Pruebas moleculares rápidas para diagnóstico de tuberculosis, un ascenso en calidad para los programas de tuberculosis: modelo chileno

Abstract

Active screening for forms of tuberculosis (TB) that transmit disease in the community is a strategy that reduces the gaps in undiagnosed cases and contributes to the goal of eliminating this disease. To optimize the performance of case location, a search should be carried out aimed at people with respiratory symptoms, who belong to vulnerable groups (home contacts, in people deprived of liberty or living with HIV, older adults, diabetics, immigrants from countries with a prevalence of TB, indigenous peoples, homeless people and alcohol and drug users). In these symptomatic groups called “Presumptive TB Cases” (PTC) the use of rapid molecular tests (RMT) in sputum and chest x-ray are more efficient than the use of traditional sputum smear because they are more sensitive methods. Chile maintains a stable rate of TB ranging from 10 to 15 per 100.000 inhabitants and has incorporated the use of RMT into an automated enzyme-linked immunoassay (ELISA) amplification of a specific of Mycobacterium tuberculosis nucleic acid sequence. Since 2019 the use of RMT has been increasing until 95% of diagnosed of confirmed pulmonary TB are established by this technology by 2023. Additionally, it was possible to know the susceptibility of the strains to Rifampicin, the main drug for the treatment of TB.