{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:57:43Z","timestamp":1777985863263,"version":"3.51.4"},"reference-count":55,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. bras. epidemiol."],"abstract":"<jats:p>ABSTRACT  Objective:  To analyze the factors associated with the frequency of false negative results for the RMT-TB test for the diagnosis of pulmonary tuberculosis in the state of S\u00e3o Paulo.  Methods:  Cross-sectional study using pulmonary tuberculosis cases from the state of S\u00e3o Paulo reported in the TB-WEB system between 2014 and 2023. RMT-TB results were compared with sputum smear microscopy, sputum culture, and sensitivity testing. Subsequently, variables with p&lt;0.05 in the statistical tests were included in the logistic regression.  Results:  There was a significant increase in the use of RMT-TB over the years, reaching 76% of cases in 2023. Analysis of the test accuracy revealed high agreement with sputum culture (82.6%) and the sensitivity test (98.4%), although it showed lower agreement with sputum smear microscopy (78.5%). The study identified factors associated with false-negative results on the RMT-TB, such as advanced age, female sex, HIV status, imprisoned, and a normal chest X-ray. Logistic regression confirmed that these factors increase the likelihood of false-negative results.  Conclusion:  The RMT-TB is an effective tool for diagnosing pulmonary tuberculosis, but the interpretation of results must consider each patient\u2019s specific risk factors, especially in high-risk populations. The study highlights the importance of combining the RMT-TB with other diagnostic methods and clinical evaluation to ensure accurate diagnosis and appropriate treatment.<\/jats:p>","DOI":"10.1590\/1980-549720260012","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T11:48:07Z","timestamp":1775216887000},"source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with false-negative results from the rapid molecular test for pulmonary tuberculosis in the state of S\u00e3o Paulo, Brazil"],"prefix":"10.1590","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7008-8023","authenticated-orcid":false,"given":"Alexandre Tadashi Inomata","family":"Bruce","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil; Universidade Federal do Amazonas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5544-910X","authenticated-orcid":false,"given":"Mariana Gaspar Botelho Funari de","family":"Faria","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-1733","authenticated-orcid":false,"given":"Rubia Laine de Paula","family":"Andrade","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-8714","authenticated-orcid":false,"given":"Ricardo Alexandre","family":"Arc\u00eancio","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7541-5591","authenticated-orcid":false,"given":"Ione Carvalho","family":"Pinto","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8085-1945","authenticated-orcid":false,"given":"Dulce","family":"Gomes","sequence":"additional","affiliation":[{"name":"Universidade de \u00c9vora,  Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1011-6053","authenticated-orcid":false,"given":"Esron Soares Carvalho","family":"Rocha","sequence":"additional","affiliation":[{"name":"Universidade Federal do Amazonas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6481-7287","authenticated-orcid":false,"given":"Manoel Eduardo de Aquino","family":"Tavares","sequence":"additional","affiliation":[{"name":"Universidade Federal do Amazonas,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4073-2735","authenticated-orcid":false,"given":"Aline Aparecida","family":"Monroe","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"Global tuberculosis report 2023","year":"2023"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1590\/s1806-37562017000000443","article-title":"Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs","volume":"44","author":"Silva DR","year":"2018","journal-title":"J Bras Pneumol"},{"key":"ref3","series-title":"Como as Na\u00e7\u00f5es Unidas apoiam os Objetivos de Desenvolvimento Sustent\u00e1vel no Brasil","year":"2022"},{"key":"ref4","series-title":"Programa Brasil Saud\u00e1vel: unir para cuidar","year":"2024"},{"issue":"esp.","key":"ref5","article-title":"Tuberculose 2024","year":"2024","journal-title":"Boletim Epidemiol\u00f3gico"},{"key":"ref6","series-title":"Plano estadual de S\u00e3o Paulo pelo fim da tuberculose como problema da sa\u00fade p\u00fablica: 2022 a 2025","year":"2022"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"89","DOI":"10.11606\/s1518-8787.2021055003125","article-title":"Efetividade do GeneXpert\u00ae no diagn\u00f3stico da tuberculose em pessoas que vivem com HIV\/aids","volume":"55","author":"Faria MGBF","year":"2021","journal-title":"Rev Saude Publica"},{"key":"ref8","doi-asserted-by":"crossref","DOI":"10.1590\/1518.8345.4412.3441","article-title":"Impact of the GeneXpert\u00ae MTB\/RIF rapid molecular test on tuberculosis detection: temporal trends and vulnerable territories","volume":"29","author":"Berra TZ","year":"2021","journal-title":"Rev Latino-Am Enfermagem"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1590\/s1806-37562017000000201","article-title":"Rapid molecular test for tuberculosis: impact of its routine use at a referral hospital","volume":"44","author":"Casela M","year":"2018","journal-title":"J Bras Pneumol"},{"key":"ref10","series-title":"Portaria no 48, de 10 de setembro de 2013. Torna p\u00fablica a decis\u00e3o de incorporar o Teste Xpert MTB\/RIF para diagn\u00f3stico de casos novos de tuberculose e detec\u00e7\u00e3o de resist\u00eancia \u00e0 rifampicina no Sistema \u00danico de Sa\u00fade - SUS","year":"2013"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.1590\/1980-265x-tce-2023-0288en","article-title":"Use of the rapid molecular test for tuberculosis among people deprived of liberty: a scoping review","volume":"33","author":"Naves EF","year":"2024","journal-title":"Texto Contexto Enferm"},{"issue":"1","key":"ref12","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1186\/s12913-018-3762-x","article-title":"Impact of Xpert MTB\/RIF and decentralized care on linkage to care and drug-resistant tuberculosis treatment outcomes in Johannesburg, South Africa","volume":"18","author":"Evans D","year":"2018","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"ref13","first-page":"114","article-title":"Impact of GeneXpert MTB\/RIF for rapid tuberculosis diagnosis and rifampicin resistance detection in South-Western Nigeria","volume":"3","author":"Usman SO","year":"2018","journal-title":"Sokoto J Med Lab Sci"},{"issue":"8","key":"ref14","doi-asserted-by":"crossref","first-page":"899","DOI":"10.5588\/ijtld.17.0729","article-title":"Impact of scaling up Xpert\u00ae MTB\/RIF testing for the detection of rifampicin-resistant TB cases in Karachi, Pakistan","volume":"22","author":"Awan WM","year":"2018","journal-title":"Int J Tuberc Lung Dis"},{"issue":"esp.","key":"ref15","article-title":"Tuberculose 2021","year":"2021","journal-title":"Boletim Epidemiol\u00f3gico"},{"issue":"6","key":"ref16","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/j.surg.2015.12.029","article-title":"ROC-ing along: evaluation and interpretation of receiver operating characteristic curves","volume":"159","author":"Carter JV","year":"2016","journal-title":"Surgery"},{"key":"ref17","series-title":"O uso do teste molecular r\u00e1pido para o diagn\u00f3stico de tuberculose em crian\u00e7as e o padr\u00e3o espacial da TB infantil em Ribeir\u00e3o Preto (SP)","author":"Alves YM","year":"2022"},{"issue":"2","key":"ref18","doi-asserted-by":"crossref","DOI":"10.1590\/1806-3713\/e20180185","article-title":"Performance of diagnostic tests for pulmonary tuberculosis in indigenous populations in Brazil: the contribution of Rapid Molecular Testing","volume":"45","author":"Malacarne J","year":"2019","journal-title":"J Bras Pneumol"},{"key":"ref19","series-title":"Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children","year":"2013"},{"key":"ref20","series-title":"Relat\u00f3rio global sobre tuberculose 2024","year":"2024"},{"issue":"3","key":"ref21","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193988","article-title":"Impact of introduction of Xpert MTB\/RIF test on tuberculosis (TB) diagnosis in a city with high TB incidence in Brazil","volume":"13","author":"Pereira GR","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"ref22","first-page":"CD009593","article-title":"Xpert\u00ae MTB\/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults","volume":"2014","author":"Steingart KR","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"ref23","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.jinf.2012.02.012","article-title":"Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB\/RIF assay: a meta-analysis","volume":"64","author":"Chang K","year":"2012","journal-title":"J Infect"},{"issue":"11","key":"ref24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001120","article-title":"Rapid diagnosis of tuberculosis with the Xpert MTB\/RIF assay in high burden countries: a cost-effectiveness analysis","volume":"8","author":"Vassall A","year":"2011","journal-title":"PLoS Med"},{"issue":"10","key":"ref25","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1097\/QAD.0b013e32830007cd","article-title":"Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa","volume":"27","author":"Lawn SD","year":"2008","journal-title":"AIDS"},{"issue":"1","key":"ref26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1556\/1886.2021.00021","article-title":"Tuberculosis challenges: resistance, co-infection, diagnosis, and treatment","volume":"12","author":"Heidary M","year":"2022","journal-title":"Eur J Microbiol Immunol (Bp)"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1086\/518656","article-title":"Facing the crisis: improving the diagnosis of tuberculosis in the HIV era","volume":"196","author":"Perkins MD","year":"2007","journal-title":"J Infect Dis"},{"issue":"3","key":"ref28","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1183\/09031936.00170411","article-title":"TB and MDR\/XDR-TB in European Union and European Economic Area countries: managed or mismanaged?","volume":"39","author":"Migliori GB","year":"2012","journal-title":"Eur Respir J"},{"issue":"1","key":"ref29","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1164\/rccm.201101-0056OC","article-title":"Evaluation of the Xpert MTB\/RIF assay for the diagnosis of pulmonary tuberculosis in a high HIV prevalence setting","volume":"184","author":"Theron G","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"ref30","series-title":"Companion handbook to the WHO guidelines for the programmatic management of drug-resistant tuberculosis","year":"2014"},{"issue":"10","key":"ref31","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0141011","article-title":"Evaluating the diagnostic accuracy of Xpert MTB\/RIF assay in pulmonary tuberculosis","volume":"10","author":"Sharma SK","year":"2015","journal-title":"PLoS One"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/1741-7015-9-81","article-title":"The impact of diabetes on tuberculosis treatment outcomes: a systematic review","volume":"9","author":"Baker MA","year":"2011","journal-title":"BMC Med"},{"issue":"3","key":"ref33","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.idc.2010.04.012","article-title":"The convergence of the global smoking, COPD, tuberculosis, HIV, and respiratory infection epidemics","volume":"24","author":"van Zyl-Smit RN","year":"2010","journal-title":"Infect Dis Clin North Am"},{"issue":"11","key":"ref34","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa0907847","article-title":"Rapid molecular detection of tuberculosis and rifampin resistance","volume":"363","author":"Boehme CC","year":"2010","journal-title":"N Engl J Med"},{"key":"ref35","series-title":"Xpert MTB\/RIF implementation manual. Technical and operational guidance","year":"2014"},{"key":"ref36","doi-asserted-by":"crossref","DOI":"10.1590\/1980-220x-reeusp-2022-0137en","article-title":"Tuberculosis from the perspective of men and women","volume":"56","author":"Silva TC","year":"2022","journal-title":"Rev Esc Enferm USP"},{"issue":"3","key":"ref37","doi-asserted-by":"crossref","first-page":"200626","DOI":"10.1183\/13993003.00626-2020","article-title":"The risk of multidrug- or rifampicin-resistance in males versus females with tuberculosis","volume":"56","author":"McQuaid CF","year":"2020","journal-title":"Eur Respir J"},{"issue":"2","key":"ref38","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1590\/S0104-07072012000200020","article-title":"O cuidado \u00e0 sa\u00fade da mulher com tuberculose na perspectiva do enfoque familiar","volume":"21","author":"S\u00e1 LD","year":"2012","journal-title":"Texto Contexto Enferm"},{"issue":"2","key":"ref39","first-page":"115","article-title":"Women and tuberculosis","volume":"49","author":"Connolly M","year":"1996","journal-title":"World Health Stat Q"},{"issue":"3","key":"ref40","first-page":"244","article-title":"Host genetics and tuberculosis: theory of genetic polymorphism and tuberculosis","volume":"36","author":"Aravindan PP","year":"2019","journal-title":"Lung India"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.3389\/fimmu.2018.01931","article-title":"Sex hormones determine immune response","volume":"9","author":"Taneja V","year":"2018","journal-title":"Front Immunol"},{"issue":"7","key":"ref42","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s10096-011-1485-6","article-title":"Sputum induction for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis","volume":"31","author":"Gonzalez-Angulo Y","year":"2012","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"107876","DOI":"10.1016\/j.ijid.2025.107876","article-title":"Tuberculosis and HIV coinfection: progress and challenges towards reducing incidence and mortality","volume":"155","author":"Sossen B","year":"2025","journal-title":"Int J Infect Dis"},{"issue":"4","key":"ref44","article-title":"Lateral flow urine lipoarabinomannan assay for tuberculosis diagnosis in HIV-positive inpatients and outpatients","volume":"51","author":"Pereira GR","year":"2025","journal-title":"J Bras Pneumol"},{"issue":"6","key":"ref45","doi-asserted-by":"crossref","first-page":"e903","DOI":"10.1016\/S2214-109X(23)00135-3","article-title":"Diagnostic yield of urine lipoarabinomannan and sputum tuberculosis tests in people living with HIV: a systematic review and meta-analysis of individual participant data","volume":"11","author":"Broger T","year":"2023","journal-title":"Lancet Glob Health"},{"key":"ref46","series-title":"Teste lipoarabinomanano de fluxo lateral na urina (LF-LAM) para rastreamento e diagn\u00f3stico de tuberculose ativa em pessoas suspeitas vivendo com HIV\/AIDS [Internet]. Relat\u00f3rio de recomenda\u00e7\u00e3o no 591","year":"2021"},{"issue":"7","key":"ref47","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1590\/1413-81232015217.16172015","article-title":"Tuberculose em pres\u00eddios brasileiros: uma revis\u00e3o integrativa da literatura","volume":"21","author":"Valen\u00e7a MS","year":"2016","journal-title":"Ci\u00eanc Sa\u00fade Colet"},{"issue":"12","key":"ref48","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000381","article-title":"Tuberculosis incidence and prevalence in prisons: a systematic review","volume":"7","author":"Baussano I","year":"2010","journal-title":"PLoS Med"},{"issue":"9","key":"ref49","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0044626","article-title":"A diagnostic accuracy study of Xpert\u00aeMTB\/RIF in HIV-positive patients with high clinical suspicion of pulmonary tuberculosis in Lima, Peru","volume":"7","author":"Carriquiry G","year":"2012","journal-title":"PLoS One"},{"issue":"2","key":"ref50","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1148\/radiol.2017162326","article-title":"Deep learning at chest radiography: automated classification of pulmonary tuberculosis by using convolutional neural networks","volume":"284","author":"Lakhani P","year":"2017","journal-title":"Radiology"},{"issue":"5","key":"ref51","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1093\/cid\/ciy967","article-title":"Development and validation of a deep learning-based automatic detection algorithm for active pulmonary tuberculosis on chest radiographs","volume":"69","author":"Hwang EJ","year":"2019","journal-title":"Clin Infect Dis"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"830515","DOI":"10.3389\/fmed.2022.830515","article-title":"A systematic review of deep learning techniques for tuberculosis detection from chest radiograph","volume":"9","author":"Oloko-Oba M","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"ref53","series-title":"The use of molecular line probe assays for the detection of resistance to isoniazid and rifampicin","year":"2016"},{"issue":"4","key":"ref54","doi-asserted-by":"crossref","DOI":"10.1128\/mBio.00812-17","article-title":"The New Xpert MTB\/RIF Ultra: improving detection of mycobacterium tuberculosis and resistance to rifampin in an assay suitable for point-of-care testing","volume":"8","author":"Chakravorty S","year":"2017","journal-title":"mBio"},{"issue":"2","key":"ref55","article-title":"Consenso sobre o diagn\u00f3stico da tuberculose da Sociedade Brasileira de Pneumologia e Tisiologia","volume":"47","author":"Silva DR","year":"2021","journal-title":"J Bras Pneumol"}],"container-title":["Revista Brasileira de Epidemiologia"],"original-title":["Fatores associados ao resultado falso-negativo do teste r\u00e1pido molecular da tuberculose pulmonar no estado de S\u00e3o Paulo, Brasil"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1415-790X2026000101013&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T11:48:13Z","timestamp":1775216893000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1415-790X2026000101013&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":55,"alternative-id":["S1415-790X2026000101013"],"URL":"https:\/\/doi.org\/10.1590\/1980-549720260012","relation":{"is-translation-of":[{"id-type":"doi","id":"10.1590\/1980-549720260012.2","asserted-by":"subject"},{"id-type":"doi","id":"10.1590\/1980-549720260012.2","asserted-by":"object"}]},"ISSN":["1980-5497","1415-790X"],"issn-type":[{"value":"1980-5497","type":"electronic"},{"value":"1415-790X","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e260012"}}