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Extrapulmonary TB (EPTB) is TB involving any part of the body other than the lungs, e.g., pleura, lymph nodes, abdomen, genitourinary tract, skin, joints, bones, meninges and other sites. A case of Presumptive Extra Pulmonary TB is identified when they exhibit symptoms and signs suggestive of EP TB.

Symptoms of EP TB are dependent on the site of TB as illustrated below.

Pulmonary TB(PTB) is primarily involves lungs. Screening should be done for the following symptoms:

Figure: Signs and Symptoms of active TB

Regular screening of Presumptive TB cases with unexplained cough of any duration should be done and checked for:

Educating patients on collection is essential to have good quality sputum. The healthcare worker (HCW)/ medical officer (MO) or the laboratory technician (LT) can educate patients on how to collect and dispense sputum.

The HCW/MO/LT provides a new sputum cup with the Laboratory Serial Number written on its side to the patient. They should explain that sputum should be collected in an open place or in a well-ventilated room; it should not be collected in closed rooms, toilets and ill-ventilated rooms

Active TB disease has 4 major symptoms (the 4 Symptom complex). Presence of any one of these symptoms without any other reason warrants evaluation for TB. These are:

Figure: Signs and Symptoms of TB

Health Volunteers

• are members of the communities where they work,
• are supported by the health system but not necessarily a part of its organization,
• and have shorter training than professional workers”

Figure: Role of Health Volunteers

Resources:

Health Volunteers/ Treatment Supporters are often the regular point of contact for a TB patient in the community. They support the TB patient during the entire episode of TB and ensure complete diagnosis and treatment. The next points of contact are with the MPHWs who periodically visit the patients to ensure specific delivery of services.  

What is Drug-Sensitive Tuberculosis (DS-TB)?

• DSTB is a case where a person is infected with TB bacteria that are susceptible to all first line anti-TB drugs. It means that all of the first line TB drugs will be effective as long as they are taken properly and regularly.

• This type of TB has the best prognosis and the shortest treatment duration.

After exposure to infective droplets containing M.TB, only a small proportion gets infected and further progresses to active TB disease.

The Senior TB Laboratory Supervisor (STLS) is the person responsible for monitoring the day-to-day activities of all the microscopy centres and nucleic acid amplification test (NAAT) sites and is thus essential to the success of the National TB Elimination Programme (NTEP). They also ensure the quality of TB diagnostic services.

Roles of STLS at the DMC

For laboratory diagnosis of TB, different biological specimens are used.

Pulmonary TB: Sputum sample is used. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, a spot sample and a fresh morning sample is preferred for the bacteriological examination of sputum.

Extra Pulmonary TB:

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