การประเมินผลโครงการการใช้ชุดตรวจ Xpert MTB/RIF เพื่อการวินิจฉัยวัณโรคและวัณโรคดื้อยาหลายขนานใน 3 โรงพยาบาลของประเทศไทย
ชื่อผู้แต่งข้างต้นเป็นข้อความจากระเบียนผลงาน ไม่ได้ผูกกับรหัสนักวิจัย จึงกดดูผลงานอื่นของบุคคลนี้ไม่ได้ — ในคลังนี้ 142,080 ผลงาน (63.6% ของทั้งหมด) มีชื่อผู้แต่งที่เชื่อมกับหน้าผู้แต่งได้ และ 60,298 ผลงาน (27.0%) มีผู้แต่งที่ผูกกับรหัสนักวิจัยจริง ส่วนอีก 81,382 ผลงานไม่มีข้อมูลผู้แต่งเลย (มีชื่อผู้แต่งเป็นข้อความอยู่ 142,009 ผลงาน = 63.5%)
บทคัดย่อ
TB and culture is used to confirm the TB infection in Thailand. However, the sensitivity of AFB smear depends on the presence of bacilli in the sputum, the skill of laboratory staff and TB culture takes several weeks. Delayed TB diagnosis is an important contributor to TB transmission and TB mortality. The rapid molecular diagnostic technique called Xpert MTB/RIF and its program was implemented for early TB and multidrug resistant TB (MDR-TB) diagnosis in the first 3 hospitals in Thailand for 1 year. We plan to assess the impact and the feasibility of the Xpert MTB/RIF program used in clinical practice. Methods: The study was conducted at Mae Sot General Hospital, Makarak Hospital and Chonburi Hospital that received the Xpert MTB/RIF tests following the national TB program from Thai MOPH during April 2013 to May 2014. The sample size was estimated by the previous 3 year-record of each hospital. Both TB and MDR-TB suspected patients who visited in 3 hospitals between 2012 and 2015 were included. Their related demographic, clinical and laboratory data were retrospectively reviewed, collected and analyzed according to the study protocol. The in-depth interview of a doctor, 2 nurses and 2 laboratory staff in each hospital was also done. We performed descriptive analysis and compared the result divided into 3 hospitals and 3 periods which are before, during and after the Xpert MTB/RIF programmatic implementation. Result and Conclusion: An Xpert MTB/RIF for TB and MDR-TB diagnosis is quite rapid, conveniently, comfortable and suitable for the top three highest TB and MDR-TB burden hospitals. Health care providers training, technical and financial support from Thai government are seriously concern and need systematic development and improvement as soon as possible. The impact to the government budget and the routine work of healh care personel will increase if we use the Xpert MTB/RIF test instead of the traditional acid fast bacilli one. However, the effectiveness and the economic evaluation should be the future studies.