Bidirectional screening is a method to identify cases in diseases which have predisposition to each other or has a significant influence on each other. For example TB and HIV, where having HIV increases risk of developing TB and cases with TB would have poor outcomes if co-infected with HIV.

Screening for TB is done through four-symptoms complex based screening or through Chest X-ray. Screening for the linked disease is carried out as per the policies of the corresponding health program.

Intensified Case Finding (ICF) is a case finding approach between Active and Passive approaches. Here individuals coming in contact with the health system through any activity are screened actively for symptoms of TB and referred for testing.

This approach brings the benefit of active case finding approach by active screening for TB symptoms, but does limit the extensive effort required by restricting to only those people who has some or the other healthcare problem. This approach is considered for people attending a healthcare facility.

Systematic screening of all individuals of a defined population is known as active case finding.  It is applied outside of health facilities at the community level by the health system.

Objective of ACF is to:

TPT treatment options recommended under NTEP include:

• 3-month weekly Isoniazid and Rifapentine (3HP)
• 6-months daily isoniazid (6H)

What is the "continuum of TB Care"?

The process for testing is initiated with a request for test and ends with the reporting of test results. In built into the process of testing is also the process of specimen collection and transportation.

Different tuberculosis (TB) case finding strategies are deployed in public and private sector for early detection of TB patients and their subsequent linkage to treatment facility.

Public Sector:

A nucleic acid test (NAT) is a technique used to detect a particular nucleic acid sequence. In general, a NAT is used to detect and identify a particular species or subspecies of an organism (e.g., a virus or bacteria that acts as a pathogen in blood, tissue or urine).

As the genetic material is usually present at a low level, many NATs include a step that amplifies the genetic material (i.e., makes many copies of it) – such NATs are called nucleic acid amplification tests (NAATs)

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Discuss the various norms and requirement to establish the same.