Avaliação do perfil diagnóstico, resistência de Mycobacterium tuberculosis a rifampicina e proposta de aplicativo móvel para assistência ao tratamento da tuberculose em hospital de referência do estado da Paraíba

Abstract

Tuberculosis is an infectious disease and a serious public health problem worldwide. According to the WHO in its latest report, about 10 million people contracted tuberculosis and 1.5 million people died from the disease. In 2018, about half a million people developed rifampin-resistant tuberculosis and 78% of them presented the multidrug-resistant form. In Brazil, about 76,000 new cases were reported and 4,500 deaths from the disease. The present study aimed to evaluate the diagnostic profile performed for the detection of tuberculosis by molecular and phenotypic means, resistance to rifampicin and from the observed data to propose innovation through the creation of a mobile application prototype to assist in the treatment of tuberculosis in patients seen at the referral hospital for infectious diseases in Paraíba. The research has an epidemiological, retrospective, observational, transversal, individualized character with an emphasis on quantitative data analysis and from these the development of a mobile application prototype, structured through the Adobe XD platform. The data were stored in a tabular structure and consist of numerical and categorical values, as well as time series. From May 2015 to May 2019, an average of 827 molecular diagnostic tests were performed annually as the main test for tuberculosis detection. The incidence of cases with results of sensitivity to rifampicin indicated in the Rapid Molecular Test (TRM) was higher than the cases that presented resistance; 95.52% cases with verified sensitivity and 4.47% resistance. The tests that showed a mutation of the rpoB gene varied and of these, only 18 continued with the Antimicrobial Sensitivity Test (TSA), of which 12 obtained a concordant phenotypic result in the TSA compared to the TRM, with confirmed rifampicin resistance and 6 patients presented discordant result; the phenotypic profile had a higher resistance index for isoniazid 24.07% and the highest sensitivity, 98.14% for ethambutol. The prototype entitled “TRATE TB” was developed based on the scenario created from data analysis, with visual access, handling and simulation of features such as: scheduling of reminders for medication intake, exam attachment, appointment scheduling, inventory registration medicines, generating progress reports and adhering to treatment, as well as sharing information with medical and family assistance. Even partially remotely, the “TRATE TB” application should play a considerable role in assisting patients undergoing treatment for tuberculosis at the Reference Hospital Clementino Fraga, in addition to the fact that easy access to resources in a single tool can intervene in the number of new cases, in the development of resistance to the main drugs, abandonment of treatment and cure of the patient.