Avaliação do Sistema de Vigilância da Tuberculose Drogarresistente, Brasil, 2013-2017*

Tourinho, Bruna Dias; Oliveira, Patricia Bartholomay; Silva, Gabriela Drummond Marques da; Rocha, Marli Souza; Penna, Estefania Quilma Andrade de Araújo; Pércio, Jadher

doi:10.5123/s1679-497420120000100010

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…These findings may align with global recommendations for increased funding to achieve universal access [13,14]. They also contribute to the approach proposed by the Brazilian Ministry of Health to improve indicators and identify areas for restructuring the expansion of laboratory and diagnostic networks, keeping as a target the eradication of TB in Brazil by 2035 [12,14].…”

Section: Public Health Implicationssupporting

confidence: 67%

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

Aguilar‐Jiménez,

Pelissari,

Diaz‐Quijano

2023

Tropical Med Int Health

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ObjectiveTo evaluate the association between the availability of GeneXpert®MTB/RIF in municipalities and the proportion of people who have access to this diagnostic technology for tuberculosis (TB), as well as the resistance detected by the surveillance system in Brazil.MethodsWe analysed 4998 Brazilian municipalities that reported 432,937 new TB cases between 2015 and 2020. We compared municipalities with and without the availability of GeneXpert®MTB/RIF regarding the effective access to GeneXpert®MTB/RIF diagnosis and the prevalence of detected resistance.ResultsMunicipalities with at least one GeneXpert®MTB/RIF system had three times (95% CI 2.9–3.0) the access to diagnostic tests and 80.4% (95% CI 70.6%–90.2%) higher detection of resistance, compared with municipalities without this technology. We estimated that there have been 1890 cases of undetected resistance during this period in the country.ConclusionsThe availability of GeneXpert®MTB/RIF system in the municipality increased the sensitivity of the surveillance for detecting TB resistance.Public Health ImplicationsIt is a priority to strengthen laboratory networks and narrow the gap in access to rapid diagnosis in remote areas to improve the detection and control of drug‐resistant tuberculosis.

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Section: Public Health Implicationssupporting

confidence: 67%

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

Aguilar‐Jiménez,

Pelissari,

Diaz‐Quijano

2023

Tropical Med Int Health

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“…Previous studies suggested that the sensitivity to drug-resistant TB identification is only 46.6% in Brazil 10 . The present study did not intend to calculate the sensitivity, but to quantify the non-detected resistance cases due to a lack of proper technology.…”

Section: Public Health Implicationsmentioning

confidence: 99%

“…These findings may align with global recommendations for increased funding to achieve universal access 11,12 . They also contribute to the approach proposed by the Brazilian Ministry of Health to improve indicators, identifying areas for restructuring the expansion of laboratory and diagnostic networks, keeping as a target the eradication of TB in Brazil by 2035 10,12 .…”

Section: Public Health Implicationsmentioning

confidence: 99%

How has the municipal availability of theGeneXpert^®MTB/RIFsystem affected the detection of drug-resistant tuberculosis in Brazil?

Aguilar-Jiménez

Pelissari

Díaz-Quijano

2023

Preprint

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Objective: To evaluate the association between the availability of GeneXpert ® MTB/RIF in municipalities and the proportion of people who have access to this diagnostic technology for tuberculosis (TB), as well as the resistance detected by the surveillance system in Brazil. Methods: We analyzed 4,998 Brazilian municipalities that reported 432,937 new TB cases between 2015 and 2020. We compared municipalities with and without the availability of GeneXpert ® MTB/RIF regarding the prevalence of effective access to GeneXpert ®MTB/RIF diagnosis and that of detected resistance. Results: Municipalities with at least one GeneXpert ®MTB/RIF system had three times (95%CI 2.9-3.0) the access to diagnostic tests and 80.4% (95%CI 70.6%-90.2%) higher detection of resistance, compared to municipalities without this technology. We estimate that there have been 2,110 cases of undetected resistance during this period in the country. Conclusions: The availability of GeneXpert ® MTB/RIF system in the municipality increased the sensitivity of the surveillance for detecting TB resistance. Public Health implications. It is a priority to strengthen laboratory networks and narrow the gap in access to rapid diagnosis in remote areas to improve the detection and control of drug-resistant tuberculosis. Keywords: GeneXpert MTB/RIF, tuberculosis, drug resistance, rapid diagnosis, access.

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“…Currently, eliminating MDR-TB presents a major challenge, as recognized by the WHO, given its critical impact on public health and potential threat it poses to global security and disease prevention. This leads to less efficient therapeutic schemes and is associated with relapses and unfavorable outcomes 7 , 8 , 9 . Additionally, there is limited data on the catastrophic costs incurred by patients with MDR-TB in countries with a high TB burden 10 , 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Analysis of catastrophic costs incurred by patients with multidrug-resistant tuberculosis in an outpatient clinic in the state of Rio de Janeiro

Medeiros,

Moreira,

Neves

et al. 2023

Rev. Soc. Bras. Med. Trop.

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Background: Multidrug-resistant tuberculosis (MDR-TB) is a serious global public health concern associated with social vulnerability. In Brazil, the Unified Health System (SUS, Portuguese) provides free diagnosis and treatment for MDR-TB; however, other expenses may still be incurred for patients and their families which, according to the World Health Organization (WHO), can be catastrophic when these costs surpass 20.0% of the annual household income. This study aimed to assess the extent of catastrophic costs related to the diagnostic and therapeutic aspects of MDR-TB among patients receiving care at an outpatient clinic in Rio de Janeiro. Methods: This prospective study used convenience sampling from July 2019 to June 2021. Data regarding direct and indirect costs were collected using a standardized questionnaire endorsed by the WHO. To analyze any impoverishment occurred from MDR-TB, a threshold established by the Brazilian Institute of Geography and Statistics for 2019 and 2020 of US$ 79,562 and US$ 94,5273, respectively, was applied. Descriptive statistics were used for data analysis, including mean; standard deviation; variation coefficient; median; and maximum, minimum, and interquartile ranges. Results: A total of 65 patients were interviewed. Among the participants, 73.8% experienced catastrophic costs, with indirect costs exerting the most significant impact (median: US$ 3,825.9), in contrast to direct costs (median: US$ 542.7). When comparing the periods before and after diagnosis, the prevalence of poverty increased from 12.0% to 28.0%. Conclusions: Despite the support from the SUS in Brazil, diagnostic and therapeutic cascades incur additional costs, exacerbating social vulnerability among patients with MDR-TB.

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Avaliação do Sistema de Vigilância da Tuberculose Drogarresistente, Brasil, 2013-2017*

Cited by 7 publications

References 14 publications

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

How has the municipal availability of theGeneXpert^®MTB/RIFsystem affected the detection of drug-resistant tuberculosis in Brazil?

Analysis of catastrophic costs incurred by patients with multidrug-resistant tuberculosis in an outpatient clinic in the state of Rio de Janeiro

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Avaliação do Sistema de Vigilância da Tuberculose Drogarresistente, Brasil, 2013-2017*

Cited by 7 publications

References 14 publications

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

How has the municipal availability of the GeneXpert®MTB/RIF system affected the detection of drug‐resistant tuberculosis in Brazil?

How has the municipal availability of theGeneXpert®MTB/RIFsystem affected the detection of drug-resistant tuberculosis in Brazil?

Analysis of catastrophic costs incurred by patients with multidrug-resistant tuberculosis in an outpatient clinic in the state of Rio de Janeiro

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How has the municipal availability of theGeneXpert^®MTB/RIFsystem affected the detection of drug-resistant tuberculosis in Brazil?