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

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dc.contributor.authorMbelele, P.M.
dc.contributor.authorMohamed, S.Y.
dc.contributor.authorSauli, E.
dc.contributor.authorMpolya, E.A.
dc.contributor.authorMfinanga, S.G.
dc.contributor.authorAddo, K.K.
dc.contributor.authorHeysell, S.K.
dc.contributor.authorMpagama, S.G.
dc.date.accessioned2019-06-26T12:50:41Z
dc.date.available2019-06-26T12:50:41Z
dc.date.issued2018-10
dc.description.abstractEarly 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.en_US
dc.identifier.otherDOI: 10.4103/ijmy.ijmy_135_18
dc.identifier.otherVol.7(4): pp 299
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/31057
dc.language.isoenen_US
dc.publisherInternational Journal of Mycobacteriologyen_US
dc.subjectAnti-tuberculosis therapyen_US
dc.subjectDiagnosisen_US
dc.subjectDrug-resistant tuberculosisen_US
dc.subjectMolecular methodsen_US
dc.subjectMonitoringen_US
dc.titleMeta-narrative review of molecular methods for diagnosis and monitoring of multidrug-resistant tuberculosis treatment in adultsen_US
dc.typeArticleen_US

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