Avaliação da reação em cadeia da polimerase no diagnóstico da tuberculose pulmonar em pacientes indígenas e não indígenas

Abstract

The DOTS strategy was proposed by the World Health Organization (WHO) in 1993 with the objective of containing the global expansion of tuberculosis (TB). This strategy emphasizes the decentralization of diagnosis and treatment in order to increase the access of the population to the health system, while maintaining the quality of health care through supervision, quality control and monitoring. The goals of the WHO have been the detection of 70% of the patients with active TB, in addition to the treatment success of at least 85% of the cases detected. In countries that have achieved high levels of implementation of the DOTS strategy, the overall rate of treatment success has increased from 60% to 82%. However, case detection remained stable at 43%.(1) Therefore, the increase in the case detection of pulmonary TB has come to be considered an additional worldwide strategy for the 2006 to 2009 period.(2) The majority of studies that evaluate molecular biology techniques for the diagnosis of TB have been carried out in industrialized countries, and few studies have evaluated the clinical usefulness of such techniques as routine procedures.(3-5) In developing countries, the analysis of molecular biology techniques in the diagnostic field has not been prioritized, due to its elevated costs, technical and operational difficulties of implementation, even in reference laboratories, and due to the lack of information on its clinical relevance and/or the cost-effectiveness ratio in different clinical scenarios. Among the few reports described in these regions, most of those evaluating new molecular methods for the diagnosis of TB are based on laboratory diagnostic criteria or on the use of clinical information to evaluate conflicting results.(6-7) In addition, Evaluating the efficiency of polymerase chain reaction in diagnosing pulmonary tuberculosis in indigenous and non-indigenous patients