EVALUATION OF THE MOLECULAR RAPID TEST METHOD FOR TUBERCULOSIS CASE DETECTION IN SEVERAL HOSPITALS IN EAST INDONESIA DURING 2014-2018

Abstract

Tuberculosis (TB) is a major public health issue that remains difficult to detect. Despite its low sensitivity and specificity, the most widely used TB examination method is sputum smear microscopy. The molecular rapid test method with expert microorganisms for tuberculosis/rifampicin (X-pert MTB/RIF) has better sensitivity and specificity than sputum smear microscopy. This study aimed to evaluate the utilization of molecular rapid test in several hospitals in East Indonesia. The design of this study was a cross sectional. Data on patients were collected by enumerator and the health facilities’ TB team using the TB Forms 01, 04, 05, and 06. The data collected included patient characteristics, examination objectives, referral origin, specimen type, reference hospital, and molecular test results. This study included 16,186 patients, with 71% having molecular rapid testing method and the remaining 29% having a combination of molecular rapid test and microscopic method. Most of the patients were male (60%), aged 15-54 years (63.3%), and from internal health facilities (67.1%). The patient’s status was mostly “new cases” (77.4%), and 99.9% of the specimens were sputum. For the past five years (2014-mid 2018), most patients sought an examination for drug-sensitive TB, then drug-resistant tuberculosis (DR-TB), and at least tuberculosis-human immunodeficiency virus (TB-HIV) and tuberculosis-diabetes mellitus (TB-DM). There was an increase in the number of patients tested using molecular rapid test during the 2014-2018 period in the East Indonesia region. The most significant increase in patients using the molecular rapid test detection method was in 2017. The high increase in the use molecular rapidSOUTHEAST ASIAN J TROP MED PUBLIC HEALTH
testing 2017 was related to its exclusion with the Ministry of Health Regulations number 67 in 2016 about tuberculosis control.