Secretaría de Salud Municipal de Santiago de Cali, Cali, Colombia; Doctorado en Salud, Universidad del Valle, Cali, Colombia.
Doctorado en Salud, Universidad del Valle, Cali, Colombia; Grupo de Epidemiología y Salud Poblacional, Escuela de Salud Pública, Universidad del Valle,Cali, Colombia.
Biomedica. 2020 Dec 2;40(4):626-640. doi: 10.7705/biomedica.5272.
Introduction: The Xpert MTB/RIF™ is a rapid molecular test that diagnoses tuberculosis and rifampin resistance. Since 2010, it is recommended by the World Health Organization (WHO) and although it was introduced in Colombia since 2012, the results of its implementation are unknown. Objective: To describe the coverage and fidelity in the implementation of the Xpert MTB/RIF™ in patients with pulmonary tuberculosis in a city with a high burden for the disease in Colombia. Materials and methods: We conducted a retrospective, descriptive study of cases from a tuberculosis program in Cali between 2013 and 2019. We estimated the coverage as the total number of tests used compared to the cases registered in the program and the fidelity based on international Xpert MTB/RIF™ implementation protocols. We performed a multivariate analysis of multiple correspondences between the test and the sociodemographic variables. Results: We included 6,328 patients with pulmonary tuberculosis of whom 181 were drugresistant. The Xpert MTB/RIF™ coverage was 10,3% (n=655) with an annual variation between 0.2% and 23%. Loyalty among the highest risk groups of MDR-TB was 46.8%. The use of the test was related to being an Afro-Colombian man between 41 and 60 years of age. Conclusions: The coverage of the Xpert MTB/RIF in Cali is low and its use does not follow the recommended prioritization for its implementation. Implementation strategies are required for its proper use to contribute to the goal of ending tuberculosis.
Xpert MTB/RIF™ 是一种快速分子检测方法，可用于诊断结核病和利福平耐药性。自 2010 年以来，世界卫生组织（WHO）推荐使用该方法，尽管 2012 年已在哥伦比亚引入，但实施效果尚不清楚。目的：描述在哥伦比亚一个结核病负担较高的城市中，Xpert MTB/RIF™ 在肺结核患者中的应用覆盖范围和忠实度。材料与方法：我们对 2013 年至 2019 年卡利结核病项目中的病例进行了回顾性描述性研究。我们根据国际 Xpert MTB/RIF™ 实施协议，将覆盖率定义为实际使用的检测数量与登记在项目中的病例数量之比，将忠实度定义为检测与患者的社会人口学变量之间的多变量对应分析的比值。结果：我们纳入了 6328 例肺结核患者，其中 181 例为耐药患者。Xpert MTB/RIF™ 的覆盖率为 10.3%（n=655），每年的变化范围为 0.2%至 23%。MDR-TB 高危人群的忠实度为 46.8%。该检测的使用与 41 至 60 岁的非裔哥伦比亚男性有关。结论：卡利市 Xpert MTB/RIF 的覆盖率较低，其使用并未遵循推荐的实施优先顺序。需要实施实施策略，以确保正确使用该检测方法，从而为终结结核病的目标做出贡献。
