To improve detection rate of Multiple Drug Resistant Tuberculosis (MDR-TB), the government is planning to open 40 additional TB containment laboratories across India to ensure more patients have access to liquid culture testing method. To be set up by the Ministry of Health of Family Welfare under its Revised National Tuberculosis Programme (RNTCP), these new laboratories will come up at various government medical colleges.
To improve detection rate of Multiple Drug Resistant Tuberculosis (MDR-TB), the government is planning to open 40 additional TB containment laboratories across India to ensure more patients have access to liquid culture testing method. To be set up by the Ministry of Health of Family Welfare under its Revised National Tuberculosis Programme (RNTCP), these new laboratories will come up at various government medical colleges.
Liquid culture testing is considered as a gold standard by World Health Organisation (WHO) for TB detection. In case of suspicion of MDR-TB, experts recommend samples be subjected to second line drug susceptibility testing (DST) via liquid culture.
Besides confirming MDR-TB, the test also helps determine drugs that can treat patients. WHO strongly recommends it be offered to patients co-infected with TB and HIV, paediatric TB, extra pulmonary TB, and smear negative TB cases.
“There is a need to improve the sensitivity of existing tools to improve the detection rate, especially in high burden laboratories where more number of TB and MDR-TB cases are detected,” said Dr Sarman Singh, Professor and Head, Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences.
“Inaccurate and incomplete diagnosis of MDR-TB continues to be a challenge in public and private sectors. This often leads to delayed or inappropriate treatment; perpetuating the spread of TB infection, especially the drug resistant variety,” said Varun Khanna, Managing Director, Becton Dickinson India associated with RNTCP for TB culture and DST in laboratories.
Currently, about 34 laboratories are certified by RNTCP for liquid culture tests, which are free. These are National Referral Laboratories in Bangalore, Chennai, Agra and New Delhi, and 17 Intermediate Reference laboratories across metros in India. Laboratories at six medical colleges in Jaipur, Jamnagar, Mumbai, AIIMS New Delhi, PGI Chandigarh and BHU Varanasi are also certified to conduct liquid culture tests.
Five private laboratories such as Metropolis, SRL Mumbai, SRL–Kolkata, Shankar Nethralaya Chennai and Infexn, Thane, along with one NGO laboratory, PD Hinduja in Mumbai, and one government laboratory at GTB Sewree, Mumbai are also certified to conduct the test.
DEMYSTIFYING DIAGNOSTIC TERMS
What is drug-susceptibility testing?
The test helps identify if a person has drug-resistant TB or not. It finds out what drugs the TB bacteria in their body is sensitive to. It’s done by culturing bacteria.
Conventional TB drug-testing
The conventional TB drug-testing cultures are solid-culture systems, where TB bacteria are grown on a solid surface in a laboratory (in a petri dish) over more than 30 days.
Liquid-culture systems
Liquid-culture systems are currently the standard for drug-susceptibility testing (DST) in industrialised countries. WHO recommends liquid-culture systems for low- and middle-income countries as well. The advantage of liquid-culture systems is that results come in less than two weeks
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