Análise da eficácia do teste GeneXpert MTB/RIF no diagnóstico da tuberculose em Moçambique e África do Sul entre 2016 e 2023

Abstract

Tuberculosis is a communicable disease caused by Mycobacterium tuberculosis, affecting animals and humans. This disease mainly affects lungs, but can infect other organs and the main symptoms include cough, fever evening sweating, anorexia and weight loss, with greater weight in low-income countries and middle income, including Mozambique and South Africa. The diagnosis of M. tuberculosis can be through various techniques including the Polymerase Chain Reaction due to its speed, specificity and sensitivity. The GeneXpert MTB/RIF test is widely used to the simultaneous identification of the deoxyribonucleic acid of the M. tuberculosis complex, which could detect mutations resistant to rimfapicin and the possibility of detecting new cases in shorter time. Objective: The present study aimed to evaluate the effectiveness of diagnosing tuberculosis using the GeneXpert MTB/RIF molecular test in Mozambique and South Africa. Methodology: The study was an exploratory review of literature bases, mainly: PubMed, Semanticscholar, and Google Scholar, considering the keywords: GeneXpert MTB/RIF, Tuberculosis, Diagnosis, Mozambique and South Africa. Searching for items/works scientific studies was carried out in Portuguese and English. The analysis of scientific works was carried out according to the titles, year of publication, methodology, study location and results of the study. The data were organized in protocol tables, which include the authors, the year publication date, study location, period, study objectives and sample size. THE The effectiveness of the GeneXpert MTB/RIF test in each study was evaluated according to the level of sensitivity and specificity compared to other diagnostic techniques or according to the description of test performance in study results. Results: In total, 3167 articles were obtained, of which 24 articles were included in the present study. Studies analyzing the effectiveness of GeneXpert MTB/RIF in diagnosis of tuberculosis carried out in Mozambique, although few, show a lower percentage sensitivity of GeneXpert MTB/RIF in diagnosing tuberculosis (72%) in relation to data from South Africa, which indicate a higher average sensitivity of GeneXpert MTB/RIF (83%). Studies carried out in Mozambique showed an average percentage of lower specificity (73%) compared to those in South Africa (97%). The studies carried out in South Africa show a higher level of effectiveness of the GeneXpert MTB/RIF test in diagnosis of TB, in contrast to studies carried out in Mozambique. Conclusion: The sensitivity and specificity of GeneXpert MTB/RIF in diagnosing tuberculosis in both countries was high, showing the importance of this test for diagnosis rapid tuberculosis. Studies carried out in South Africa show a higher level of effectiveness of the GeneXpert MTB/RIF test in diagnosing TB, in relation to studies carried out in Mozambique, with the need for continuous studies to better understanding differences in testing, including publishing results in journals due to the scarcity of literature.