Question : Diagnosis of Tuberculosis

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) the prevalent methods being used for diagnosis of tuberculosis under the Revised National TB Control Programme (RNTCP) in the country;

(b) whether the Government has introduced/proposes to introduce universal rapid drug susceptibility test for TB diagnosis in the public sector across the country;

(c) if so, the details thereof along with the progress made so far in expanding access to drug susceptibility test in the country, State/UT-wise;

(d) the action plan drawn by the Government to scale up molecular drug resistance testing for TB diagnosis in the country; and

(e) the other measures being taken by the Government to establish more number of TB screening/testing facilities and also to record and maintain TB patient registry in the hospitals indicating the funds provided for the purpose during each of the last three years and the current year, State/UT-wise?

(a) to (e): The prevalent method used for the diagnosis of TB is sputum smear microscopy. Drug resistant TB is diagnosed by Culture and Drug Susceptibility Testing and by rapid molecular methods. X-ray and other imaging techniques and Histopathology are used in certain cases.
In order to facilitate early diagnosis and treatment of drug resistant TB, under the Revised National TB Control Programme (RNTCP) for all patients of TB except new (first-time) pulmonary TB patients, drug susceptibility testing is also recommended. This includes all pulmonary TB re-treatment cases (patients where TB has re-appeared after being declared successfully treated earlier, failure on current first-line treatment or patients being treated after having discontinued treatment earlier). In addition, in certain key populations such as contacts of MDR TB and People Living with HIV AIDS, testing for Multi-Drug Resistant TB at the treatment initiation stage itself, is recommended.
Programmatic management of drug resistant TB (PMDT) services under RNTCP had commenced in 2007 and complete country coverage was achieved in 2013. Currently, 62 Culture & Drug Susceptibility Testing laboratories have been established across the country which include 50 Line Probe Assay laboratories. 121 Cartridge Based Nucleic Acid Amplification Test (CBNAAT) laboratories have also been established.
RNTCP has also initiated a national anti-tuberculosis drug resistance survey in a representative sample of 5214 patients comprising newly diagnosed sputum smear positive pulmonary TB cases and previously treated sputum smear positive pulmonary TB cases. This survey is the first national level survey for TB drug resistance in India. As part of the survey, the samples are subjected to susceptibility testing for 13 anti-TB drugs (5 first line drugs and 8 second line drugs).
The Central TB Division, in co-ordination with National Informatics Centre, has developed an online case-based, web-based reporting system, called Nikshay, to improve surveillance and facilitate TB case notification. For this purpose, a sum of Rs 50.60 lakh was released by the Government during financial year 2012-13.