Impact of molecular diagnostic tests on diagnostic and treatment delays in tuberculosis: a systematic review and meta-analysis
BMC Infectious Diseases·
- DOI
- 10.1186/s12879-022-07855-9
- PMID
- 36517736
- PMCID
- PMC9748908
- OpenAlex
- W4311493368
- Study type
- Systematic review
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Why this research matters now
WHO-recommended molecular diagnostics reduce delays in diagnosing and initiating tuberculosis treatment, which may improve patient outcomes and reduce transmission in high-burden settings.
Structured evidence summary
Research question
The review assessed whether molecular diagnostic tests reduce delays in tuberculosis diagnosis and treatment initiation compared to standard-of-care methods for drug-sensitive and drug-resistant tuberculosis.
Study design
Systematic review and meta-analysis of 45 studies (26 for drug-sensitive TB, 20 for drug-resistant TB) identified through searches of MEDLINE, EMBASE, Web of Science, and Global Health databases up to October 2020. Random effects meta-analyses compared time delays between molecular tests and standard methods.
Population and setting
Studies were conducted in high TB burden countries that had expanded access to molecular diagnostic tests. Setting and patient population details were not further specified in the abstract.
Main findings
For drug-sensitive TB, Xpert reduced diagnostic delay by 1.79 days and treatment initiation delay by 2.55 days compared to sputum microscopy. For drug-resistant TB, line probe assays reduced diagnostic delay by 40.09 days and treatment initiation delay by 45.32 days compared to culture drug sensitivity testing.
Public-health relevance
WHO-recommended molecular diagnostics reduce delays in diagnosing and initiating tuberculosis treatment, which may improve patient outcomes and reduce transmission in high-burden settings.
Important limitations
The review found considerable heterogeneity in how time delays were defined and reported across included studies. This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of pooled estimates, subgroup analyses, and quality assessment.
GIDS interpretation
The article was classified under Tuberculosis, Antimicrobial Resistance, Diagnostics, and Treatment topics, making it discoverable for queries about TB diagnostic innovations and delays in care pathways. This classification reflects the systematic review's scope; it does not indicate a live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.