A systematic literature review of the diagnosis of drug resistant tuberculosis using Xpert MTB/RIF assay and its potential impacts on treatment outcomes

Authors

  • Samorn Numpong The Office of Disease Prevention and Control region 9, Nakhon Ratchasima
  • Yada Toutchon The Office of Disease Prevention and Control region 9, Nakhon Ratchasima
  • Wiwat Sungkhabut The Office of Disease Prevention and Control region 9, Nakhon Ratchasima

DOI:

https://doi.org/10.14456/dcj.2020.29

Keywords:

Diagnosis, Drug Resistant Tuberculosis, Impacts

Abstract

The World Health Organization (WHO) reported that the treatment success rate of rifampicin resistant tuberculosis and multidrug resistant tuberculosis (MDR-TB) was 55.00%. Approximately 8.50% of MDR-TB eventually developed extensively drug resistant tuberculosis (XRD-TB). Early detection of TB among high-risk groups by molecular method was one among many strategies of Thailand Operational Plan to End Tuberculosis 2017-2021. The Xpert MTB/RIF assay was therefore implemented around 3-4 years ago to speed up the diagnosis of RR TB but the studies on the impacts of Xpert MTB/RIF assay on treatment outcomes were limited. The study aimed to compare time to detect DR-TB, time to initiate treatment, and time to have sputum culture conversion between patients who were diagnosed with DR-TB by Xpert MTB/RIF assay and conventional gold standard method currently used in Thailand. A systematic literature review and meta-analysis were conducted for the study. A total of 299 articles published locally and internationally from 2010 to 2017 were identified, seven of which were found to meet the study objectives. Based on the data analysis, Xpert MTB/RIF assay was found to have shortened time to detect DR-TB, time to initiate treatment, and time to obtain sputum culture conversion, taking 34.30-91.50 days, 61-62 days, and 134.50 days, respectively. Successful treatment and unfavorable outcomes were not significantly different between two groups (RR = 0.95, 95% CI: 0.47-1.91; random-effect model, I-squared (I2) = 75%) and (RR = 0.81, 95% CI: 0.44-1.50; random-effect model, I-squared = 54%). I2 showed heterogeneity between two groups so that the cause of differences could not definitely determined. In conclusion, Xpert MTB/RIF assay could shorten the time to diagnose RR TB; time to initiate treatment was also faster; and time to obtain sputum culture conversion was shorter. However, the final impact on outcome was not clearly demonstrated.

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References

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Published

2020-09-29

How to Cite

1.
Numpong S, Toutchon Y, Sungkhabut W. A systematic literature review of the diagnosis of drug resistant tuberculosis using Xpert MTB/RIF assay and its potential impacts on treatment outcomes. Dis Control J [Internet]. 2020 Sep. 29 [cited 2024 Dec. 19];46(3):303-12. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/216821

Issue

Vol. 46 No. 3 (2020): July-September

Section

Original Article

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Articles published in the Disease Control Journal are considered as academic work, research or analysis of the personal opinion of the authors, not the opinion of the Thailand Department of Disease Control or editorial team. The authors must be responsible for their articles.