Meta-narrative review of molecular methods for diagnosis and monitoring of multidrug-resistant tuberculosis treatment in adults

dc.creatorMbelele, Peter
dc.creatorMohamed, Sagal
dc.creatorSauli, Elingarami
dc.creatorMpolya, Emmanuel
dc.creatorMfinanga, Sayoki
dc.creatorAddo, Kennedy
dc.creatorHeysell, Scott
dc.creatorMpagama, Stellah
dc.date2022-08-31T09:28:52Z
dc.date2022-08-31T09:28:52Z
dc.date2019-06-04
dc.date.accessioned2022-10-25T09:20:52Z
dc.date.available2022-10-25T09:20:52Z
dc.descriptionThis research article was published by PubMed Central, 2019
dc.descriptionEarly and accurate diagnosis and rigorous clinical and microbiological monitoring of multidrug-resistant tuberculosis (MDR-TB) treatment can curb morbidity and mortality. While others are still under evaluation, the World Health Organization has recommended few novel molecular methods for MDR-TB diagnosis only. We present current molecular methods for diagnosis and monitoring of MDR-TB treatment in TB-endemic settings. A systematic meta-narrative review was conducted according to the RAMESES recommendations. Electronic databases were searched for relevant articles published in English language from January 2013 to June 2018. Based on predefined criteria, two independent reviewers extracted the key messages from relevant articles. Disagreement between them was resolved through discussion and the involvement of a third reviewer, if needed. Key messages were synthesized to create the meta-narratives for method's accuracy, drug-susceptibility capability, and laboratory infrastructure required. We included 33 articles out of 1213 records retrieved, of which 16 (48%) and 12 (36%) were conducted in high- and low-TB-endemic settings, respectively. Xpert® MTB/RIF, GenoType MTBDRplus, GenoType MTBDRsl, FlouroType™ MTBDR, TB TaqMan® array card, and DNA sequencers can accurately guide effective treatment regimens. Molecular bacterial load assay quantifies mycobactericidal impact of these regimens. Although they present inherent advantages compared to the current standard of care, they carry important limitations to implementation and/or scale-up. Therefore, considerable effort must now be directed to implementation and health systems research to maximize these forecasted benefits for individual patient's health outcomes.
dc.formatapplication/pdf
dc.identifierhttps://doi.org/10.4103/ijmy.ijmy_135_18
dc.identifierhttps://dspace.nm-aist.ac.tz/handle/20.500.12479/1549
dc.identifier.urihttp://hdl.handle.net/123456789/95320
dc.languageen
dc.publisherPubMed Central
dc.subjectAnti-tuberculosis therapy
dc.subjectDrug-resistant tuberculosis
dc.subjectMolecular methods
dc.titleMeta-narrative review of molecular methods for diagnosis and monitoring of multidrug-resistant tuberculosis treatment in adults
dc.typeArticle

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