Análise do uso e da acurácia do teste rápido molecular no diagnóstico da tuberculose drogarresistente, no município do Rio de Janeiro, no período de 2012 a 2016

Abstract

Tuberculosis remains a serious public health problem in the world and strategies for its control are constantly drawn up. Only through evaluations of the health care process is it possible to have knowledge of the real health-disease situation of a population. An important means of collecting information to carry out this assessment is the compulsory notification of diseases, which is one of the main instruments of epidemiological surveillance (Brasil, 2002). This collected information generates secondary databases available for use in planning and management actions of health services, as well as to support research in the area. In 2014, the Rapid Molecular Test for Tuberculosis was implemented in Brazil, which detects the tuberculosis bacillus and resistance to the drug rifampicin. Before the implementation of this method, the test called “Sensitivity Test” was predominantly used as a means of diagnosis for drug resistance. Considering that evaluative studies are needed to control the results obtained by actions and services implemented in the health care network, and that we have databases available for the use and performance of these studies, this work sought to understand the effectiveness and accuracy of TRM-TB in the diagnosis of Drug-Resistant Tuberculosis when compared to previous diagnostic methods, thus contributing to the identification of results obtained in the diagnosis of Drug-Resistant Tuberculosis after the implementation of the Rapid Molecular Test for Tuberculosis. For this purpose, an analysis was performed in the databases of Rapid Molecular Test for Tuberculosis and Antimicrobial Sensitivity Test, exported from the Laboratory Environment Manager, where the number of requests for each exam was obtained, as well as their respective results for purposes of comparison. The analysis and elaboration of graphs and tables were carried out using Excel. Bibliographic surveys were carried out in relation to the protocols for carrying out the tests for theoretical foundation. The results showed that the Rapid Molecular Test for Tuberculosis has good accuracy (99.9) when compared to the Sensitivity Test, with Kappa coefficient = 79%, being considered excellent in terms of data agreement, however, the indications for the examination, thus obtaining more reliable results for the correct management of cases.