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The procedure will be the same for Laboratory Technician (LT) at Culture and Drug Susceptibility Testing (C & DST) lab for preparation and validation of reagents.

Each laboratory should have a Quality Control (QC) slide examination register.

At the District level the Senior TB Laboratory Supervisor (STLS) should record the QC slides (positive and negative) results in the register kept after preparation of each batch of reagents at the District TB Unit.

While doing sputum smear microscopy for presumptive TB patients, it is essential that the correct specimen part is tested for microscopy.

During smear preparation, each Laboratory Technician (LT) should identify a part of specimen that is either mucoid or purulent or mucopurulent, instead of thin saliva (Figure).

Acid-fast Bacilli (AFB) tend to be more in the purulent part of the smear.

Figure: Best Portion Selection for Performing Sputum Microscopy

As Tuberculosis (TB) infection spread in the form of droplet infection, healthcare workers in the TB laboratory setting need to follow standard safety precautions to prevent themselves from getting the TB infection.

Some of the safety precautions in the TB laboratory setting are as follows:

Palliative care is provided by a team of physicians, nurses and other health professionals who work together with the primary care physician and referred specialists (or for patients who don't have those, hospital or hospice staff) to provide an extra layer of support. Hence, palliative care is to be initiated by the Nodal Drug-resistant TB Centres (NDR-TBCs) in the states.

There are 2 main modalities of palliative care under the National TB Elimination Program (NTEP):

Diagnostic services are provided free of cost at all public health laboratories, for patient referrals from the private sector. Laboratory services are also purchased from certified private sector laboratories through partnership schemes.

The Drug-resistant Tuberculosis (DR-TB) care cascade is to be ensured for every patient notified/ referred.  

The figure below showcases the flow of care cascade for a patient seeking care in the private sector.

Figure: Flow of Care Cascade for a Patient Seeking Care in the Private Sector

​Resources

The various provisions under the National Tuberculosis Elimination Programme (NTEP) for Nodal Drug-resistant Tuberculosis Centre (NDR-TBC) ​are:​

Human Resource​

NTEP provides remuneration to Senior Medical Officers (SMO), Statistical Assistants (SA) and counsellors, which may be made available for the NDR-TBC once it is approved in the Program Implementation Plans (PIP).

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Capacity Building​

Every state needs to establish the State Programmatic Management of Drug-resistant Tuberculosis (PMDT) Committee. 

The functions and structure of the State PMDT Committee are listed below.

Functions

To prevent false negative results during smear microscopy, each laboratory technician needs to:

False positive results can be prevented by using the following measures: