Operationalization of rapid molecular test coverage for tuberculosis in different international contexts: a scoping review.
Diogo Henrique Mendes da Silva, Ana Beatriz Marques Valença, Melisane Regina Lima Ferreira and 4 others
PMID 42574680WHAT IT FOUND
Rapid molecular tuberculosis test coverage was defined in seven different ways across 20 studies, so reported percentages are not directly comparable.
Low coverage was tied to sample quality, request errors, staffing, funding, and distance to testing sites.
Key findings
01The included studies used seven distinct definitions of rapid molecular test coverage, including testing rates in people with symptoms, people diagnosed with TB, people with drug-resistant TB, people living with HIV, people with negative sputum smear, machine availability, and distance to facilities.
02Coverage values varied by definition and setting; for example, one study reported 10.35% among people diagnosed with TB in Colombia, and another reported 22.1% among patients with drug-resistant TB in South Korea.
03Barriers associated with low coverage included low active case finding, poor sample quality, single-shift equipment use, request errors, underfunding, management difficulties, staff shortages, and lack of water or electricity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not critically appraise the included studies, so the quality of the evidence behind each coverage value is not known. The 20 studies used different definitions of coverage, so their percentages cannot be compared directly. The included studies were mostly from specific high-burden countries and settings, so results may not apply to other health systems. Only GeneXpert MTB/RIF and Xpert MTB/RIF Ultra studies were included, so other molecular tests were not mapped. Only English, Portuguese, and Spanish studies were eligible, which may miss evidence in other languages.
Declared interests
The supplied text lists public research funding from CAPES, CNPq, and FAPESP; it does not name a commercial sponsor.
The easy way to misread this
Do not read the reported coverage percentages as proof that rapid molecular testing improves tuberculosis outcomes. This review mapped how coverage was defined and measured; it did not test treatment effects or patient outcomes.