LT-Microscopy & NAAT

The National Strategic Plan (NSP) for TB elimination 2017–25 is a bold strategic framework to drive the  acceleration of progress toward TB Elimination, and achieving the Sustainable Development Goal (SDG) and End TB targets for India. It expects to guide the activities of all stakeholders including the national and state governments, development partners, civil society organizations, international agencies, research institutions, private sector, and many others whose work is relevant to TB elimination in India.

TB is a notifiable disease in India, and TB notification has been made mandatory at the point of diagnosis since May 2012. This means that when a case of TB is diagnosed and/or put on treatment it is to be reported to the  NTEP.

TB is one of the top burdensome infectious diseases in India. It is estimated that, around 1/4th (26%) of the world's TB cases are in India, translating to about 30 Lakhs new TB cases emerging each year (TB incidence). Against this estimated incidence the National TB Elimination program reported around 19 lakh new and relapse cases in the year 2021.

• Globally, an estimated 11 million people fell ill with TB (incidence) in 2021.
• Historically, it has been the top infectious disease killer. In 2021, there were an estimated 1.4 million TB deaths and an additional 187 000 deaths among HIV-positive people.
• Three countries accounted for 42% of global cases in 2021: India (26%), the Russian Federation (8.5%) and Pakistan (7.9%).

Tuberculosis is transmitted mainly through the air via droplet nuclei generated when a TB patient coughs or sneezes. 

It is estimated that every sputum smear-positive patient spreads the infection to 10 – 15 persons annually, if untreated..

Figure: Transmission of TB bacteria through air via droplet

Resources:

Following are the risk factors that increase the chances of developing TB disease in an individual:

Figure: Risk factors for developing active TB

Resources:

Commitment at national, state and district level are required to support and facilitate the implementation of Infection Prevention and Control (IPC) measures.

The important stakeholders in IPC include:

National Airborne Infection Control Committee (NAICC) has been constituted to provide for a multi-lateral national level coordinating body, to develop national guidelines on IPC, and provide technical guidance for their implementation, evaluation, and revisions.

Composition of NAICC

Respiratory hygiene is vital to prevent the spread of TB via aerosols and person-to-person transmission.

Respiratory hygiene includes:

• Covering the nose/mouth with a tissue when coughing/sneezing and appropriate disposal of used tissues

The following work practices are recommended to ensure that microscopy laboratory technicians are not exposed to aerosols from sputum specimens.

Hand hygiene is one of the most important elements of infection control. The aim of hand washing is to remove transient micro-organisms, acquired through everyday tasks in the laboratory/ clinical setting, from the surface of the hands.

Good hand hygiene protects both patients and staff.

The World Health Organization (WHO) guidelines on “Hand Hygiene in Healthcare” describe five key situations where hand washing is required: