Abstract
PurposeThe Chulalongkorn-Hasanuddin Rifampicin-Resistant Tuberculosis Screening Tool (CUHAS-ROBUST) is an artificial intelligence–based (AI–based) application for rifampicin-resistant tuberculosis (RR-TB) screening. This study aims to elaborate on the drug-resistant TB (DR-TB) problem and the impact of CUHAS-ROBUST implementation on RR-TB screening.Design/methodology/approachA qualitative approach with content analysis was performed from September 2020 to October 2020. Medical staff from the primary care center were invited online for application trials and in-depth video call interviews. Transcripts were derived as a data source. An inductive thematic data saturation technique was conducted. Descriptive data of participants, user experience and the impact on the health service were summarizedFindingsA total of 33 participants were selected from eight major islands in Indonesia. The findings show that DR-TB is a new threat, and its diagnosis faces obstacles particularly prolonged waiting time and inevitable delayed treatment. Despite overcoming the RR-TB screening problems with fast prediction, the dubious screening performance, and the reliability of data collection for input parameters were the main concerns of CUHAS-ROBUST. Nevertheless, this application increases the confidence in decision-making, promotes medical procedure compliance, active surveillance and enhancing a low-cost screening approach.Originality/valueThe CUHAS-ROBUST achieved its purpose as a tool for clinical decision-making in RR-TB screening. Moreover, this study demonstrates AI roles in enhancing health-care quality and boost public health efforts against tuberculosis.
Highlights
Drug-resistant tuberculosis (DR-TB), and multidrug-resistant tuberculosis (MDR-TB) is a public health threat
One interview was repeated due to unclear recording, three participants retracted their interviews
Patient diagnosed with Multidrug-Resistant Tuberculosis (MDR) were included, as these patients have rifampicin resistance, along with isoniazid resistance
Summary
Drug-resistant tuberculosis (DR-TB), and multidrug-resistant tuberculosis (MDR-TB) is a public health threat. Diagnosing DR-TB is essential, and the phenotypic drug-susceptibility test (DST) is the standard reference. It is based on the observed growth of bacteria in culture. Technical problems were revealed including that it is time-consuming, open to contamination, and that there are interpretation reliability issues [2]. The line probe assay (LPA), (Hain Lifescience) is the preferred method for isoniazid resistance. These are susceptible to procedure deviation and are inaccessible in some areas due to higher costs and complex procedures, which explains why only 46% of new TB patients and 83% of previously treated patients underwent DR-TB screening [4]
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