Reacción
a. ¿Cuál es el impacto socioeconómico de la TB en la población infantil y adolescente y en susfamilias?
b. ¿Cómo puede participar de manera óptima en su atención la población adolescente con TB o que reúne los criterios para recibir el TPT?
Pregunta PICO 1: Estrategias de tamizaje en la población infantil y adolescente
¿Qué herramientas de tamizaje se deben utilizar para la detección sistemática de la enfermedad por TB en menores de 10 años que acceden a la atención de salud?
a. En menores de 10 años que acceden a la atención de salud en entornos con prevalencia alta de TB, ¿debería utilizarse el tamizaje sistemático de la TB pulmonar mediante radiografía de tórax por comparación con un patrón de referencia compuesto?
La población de interés en estas directrices es la población infantil y adolescente, que se define como sigue:
AlereLAM
Alere Determine™ TB LAM Ag
BD
Becton Dickinson
cfu
colony forming units
CI
confidence interval
CRS
New molecular assays – the Truenat MTB, MTB Plus and MTB-RIF Dx assays (Molbio Diagnostics, Goa, India), hereafter referred to as Truenat – were developed in India, and may be used at the same health system level as Xpert MTB/RIF. Of the above-mentioned assays, MTB and MTB Plus are used as initial diagnostic tests for TB, whereas MTB-RIF Dx is used as a reflex test to detect rifampicin resistance for those with positive results on the initial Truenat tests.
The development of the Xpert MTB/RIF assay (Cepheid, Sunnyvale, United States of America [USA]) was a significant step forward for improving the diagnosis of TB and the detection of rifampicin resistance globally. However, Xpert MTB/RIF sensitivity is suboptimal, particularly in smear-negative and HIV-associated TB patients. The Xpert MTB/RIF Ultra (Cepheid, Sunnyvale, USA), hereafter referred to as Xpert Ultra, was developed by Cepheid as the next-generation assay to overcome these limitations. It uses the same GeneXpert® platform as the Xpert MTB/RIF.
The political declaration at the first United Nations (UN) high-level meeting on tuberculosis (TB) held on 26 September 2018 included commitments by Member States to four new global targets (1), which were subsequently renewed at the second UN high-level meeting on TB on 22 September 2023 (2). One of these targets is that at least 90 per cent of the estimated number of people who develop TB are reached with quality-assured diagnosis and treatment in the 5-year period 2023–2027 (2).
