TB cases are generally classified on the basis of previous history of TB treatment into New and previously treated cases.

New case - A TB patient who has never had treatment for TB or has taken anti-TB drugs for less than one month is considered as a new case. 

Previously treated patients have received 1 month or more of anti-TB drugs in the past. They could be further classified as:

• TB Infection (or previously known as Latent TB infection) is a stage in between uninfected and having active TB. In this stage the person has no symptoms and can only be identified using laboratory tests.

• The vast majority of infected people may never develop TB disease. However, to achieve TB elimination, it is important to treat TB infection in people at risk of developing active TB disease.

The disposable, single-use CBNAAT cartridge is a closed system unit to hold the samples and reagents. Inside of a CBNAAT Cartridge (CBNAAT operator manual). Each cartridge consists of the following components:

Discuss the parts of the CBNAAT/ GeneXpert Cartridge and its functions.

Since the test offers quick high sensitivity/specificity diagnosis TB and simultaneous diagnosis of RIF resistance, it is indicated for use in NTEP in the following cases.

Indications for use:

1. Detection of TB in high risk Presumptive TB with high vulnerability/ Risk (such as previous history of TB, with X-ray abnormalities, HIV, Diabetes) or for use in Key populations for fast tracking diagnosis.
2. Detection of TB & DRTB in cases with high risk of DRTB (such as contacts of DR-TB)
3. Detection of RIF resistance in all TB notified cases.

Describe the various steps in the CBNAAT Testing process.

1. Sample Processing
2. Loading Sample into cartridge
3. Setting up the machine to run the test
4. Loading the cartridge
5. Obtaining the results  

It is important that patients receive their positive/negative test results and an adequate explanation of the results in a timely manner.

Time required for different Laboratory test results include:

1. Smear microscopy/follow up:1 day

2. Nucleic Acid Amplification Test (NAAT) (CBNAAT/Truenat):1-2 days

3. Line Probe Assay (LPA): 2-3 days

4. Liquid Culture DST (Drug Susceptibility testing): 22-48 days

The continuum of counselling and care is essential to constantly motivate TB patients to take their full drug regimen and complete it in due course.  

Counselling is regularly given by counsellors, treatment supporters and all those involved with patient care and treatment.  

Counselling should start at the initial point of contact as soon as the diagnosis is established and continued during all visits: 

The DMC lab register can be generated from Nikshay as a spreadsheet and stored electronically or printed for paper records.

Steps for generating DMC Register from Nikshay:  

1. Login to Nikshay Reports using your login ID and password.
2. Under Reports, click on ‘Patient wise List’ and select the option for ‘DMC Register’ (see screenshot below)