Yes, TB can be cured!

Dr Mangala Borkar

World TB Day, March 24 is observed to commemorate the declaration by Robert Koch, on this day in 1882, about the discovery of the germ (Mycobacterium Tuberculosis) that causes TB, to make the world aware about this serious disease, that mainly

spreads by breath. It is estimated that nearly 10 million persons had TB and 1.5 million died of it worldwide in 2020.

Invest to end TB, save lives

Dr Avinash Lamb

Professor, Respiratory medicine, Government Medical College, Aurangabad

The Covid pandemic has taught mankind the importance of health infrastructure. It has taken back our fight against TB by nearly a decade and we have to redouble our efforts against TB.

We as an individual, society, NGO, private sector, Government need to collectively invest financially, put in hard work,

determination and energy, so that more lives can be saved.

Those who are having cough for two weeks or more, fever, weight loss, loss of appetite should get evaluated for TB. Also, those who are diagnosed as a case of TB must take proper treatment course as per NTEP guidelines.

Clinicians who are treating TB should keep updated about new diagnostic techniques, treatment guidelines

Early detection, proper and complete treatment under observation of doctor is the key, which will help decrease the emergence of drug-resistant TB.

TB culture and drug sensitivity testing

Department of Microbiology, GMC Aurangabad

Dr Jyoti Bajaj Iravane, Professor

The Tuberculosis culture and drug susceptibility testing laboratory at Government Medical College, Aurangabad is state-of-the-art regional BSL-3 laboratory, functional since December 2013 for testing all suspected and follow-up tuberculosis samples

under National Tuberculosis Elimination Programme (NTEP).

It tests samples like sputum and body fluids (e.g. Pleural fluid, CSF, Ascitic fluid, BAL), urine, tissue and pus.

It is NABL accredited since 2015.

Different testing methods available:

1. Smear Microscopy by Fluorescent and ZN Microscopy.

2. CBNAAT i.e. Cartridge Based Nucleic Acid Amplification Test using Gene Xpert Platform

3. Line Probe Assay for susceptibility testing of the first and second line anti-tubercular drugs.

4. BACTEC MGIT 960 for liquid culture and drug susceptibility testing of the first and second line anti tubercular drugs

5. Solid Culture Testing

Nearly 40 samples are tested daily. First, the sample is subjected to microscopy.

Smear negative samples undergo CBNAAT testing.

All positive samples by smear microscopy are tested for resistance to drugs used for TB treatment. First line LPA

(INH, Rifampicin) and second line LPA (Fluroquinolones, Second line injectable drugs) if required.

CBNAAT is fully automated molecular diagnostic test that simultaneously detects Tuberculosis infection and

Rifampicin drug resistance (a reliable indicator of MDR TB). Unlike the conventional culture and drug sensitivity Test which takes 6-8 weeks, CBNAAT results are available within two hours. CBNAAT results are reported as either Negative, Rif resistance not detected, Rif resistance detected.

All CBNAAT positive samples and resistant samples on the second line LPA are subjected to liquid culture and DST.

The follow-up samples are subjected to primary culture and if positive, second line DST for individual drugs (Levofloxacin, Moxifloxacin, Kanamycin, Amikacin, Linezolid, Capreomycin) is done by BACTEC MGIT 960 system.

The turnaround times for different tests are:

1. CBNAAT – 2 days

2. Line Probe Assay for susceptibility testing of the first and second line anti-tubercular drugs – 5 days

3. BACTEC MGIT 960 ( liquid culture and DST) - 45 days.

4. Solid Culture Testing - 8 to 12 weeks