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The symptoms of cases of Non-Tuberculosis Mycobacteria (NTM) overlap with that of Tuberculosis and are nonspecific. These include chronic cough, increased sputum production, dyspnoea, low-grade fever, malaise, and weight loss. Hence presumptive NTM cases are identified as:

• discrepancies between microscopy and molecular tests (AFB Smear Positive but NAAT/ LPA negative).
• Culture is positive, but MPT 64 is negative.
• Cases that do not respond to ATT
   

External Quality Assurance for C&DST laboratories

External Quality Assurance (EQA) is a critical component of laboratory testing, as it ensures the accuracy and consistency of laboratory test processes throughout the examination of the specimen – from the point of collection to result reporting and database entry. The EQA of the C&DST laboratory under NTEP is through structured On-Site Evaluation (OSE), panel testing and retesting exercise.

Quality Improvement Activities in C&DST Laboratories

Post-examination QA Procedures in C&DST Laboratories

The examination procedure for Quality Assurance of TB and DST Laboratories includes:

1. Standard Operating Procedures (SOP)​
 Updated annually or more often as needed
 Reviewed and initiated by staff annually​
 Obsolete procedures removed, labelled as “Obsolete”

2. Calibration/ Validation- Equipment​
 Biosafety cabinets
 Safety centrifuges and autoclaves
 Thermometers, pipettes and timers​

The pre-Examination Procedure for Quality Assurance of TB and DST Laboratories includes the following aspects during post-analytical aspects:

1. Giving proper instructions to collect and transport good quality specimens:
 Appropriate specimens​
 Collection, transportation procedures​

2. Specimen monitoring requirements​:
 Documentation of specimen quality​
 Specimen rejection policy​