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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:
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:
The eligibility for TB Preventive Treatment (TPT) relies on ruling out active TB among individuals and groups who are known to have a high risk of acquiring TB.
Prioritization of the target population for TPT is based on elevated risk of progression from infection to TB disease or increased likelihood of exposure to TB disease: At-risk populations include:
Presumptive pulmonary TB patients are subjected to sputum smear microscopy (Ziehl Neelsen (ZN)/ Florescence Microscopy (FM)). Two consecutive sputum specimens will identify the vast majority (95–98%) of smear-positive TB patients
Two specimens are collected:
If one or both smears are positive, the patient is diagnosed as a microbiologically confirmed pulmonary TB case.
The National TB Elimination Program (NTEP), promotes the following principles to diagnose TB:
Microbiological Confirmation for All Cases
At a DMC, the STS primarily ensures that
1. All patient services from enrolment to outcomes for a TB patient are completed optimally. This is done by monitoring information submitted by the DMC such as referral for testing, no of people tested, no of people diagnosed with TB, initiated on treatment.
2. All the patients started on treatment are tested promptly using the appropriate follow-up testing schedule( i.e. at the end of IP and CP).
3. Maintain profile of the DMC in the Nikshay such as tagging the PHI as DMC, name of contact person and other particulars