Objective:

To assess India's preparedness toward the eradication of tuberculosis (TB) by evaluating the distribution of TB treatment units and diagnostic laboratories.

Approach:

• Study Design: Researchers used government data and visited public health facilities to determine the availability of TB tests recommended by the Indian Council of Medical Research.

Key Findings:

• India has 97 culture and drug susceptibility testing (CDST) laboratories but requires an estimated 283, indicating a 62% shortfall.
• There are 6,308 TB treatment units, compared to the recommended 7,084 based on population size.
• Only 5% of primary health centers had the complete set of TB tests recommended for their level of care.
• Acid-fast bacilli smear microscopy was available in 78% of facilities where it was recommended.
• The researchers identified 84 certified public-sector and 13 private-sector CDST laboratories, with an additional 186 needed to meet the WHO recommendation of one laboratory per 5 million people.

Interpretation:

Limited CDST capacity may delay the detection of drug-resistant Mycobacterium tuberculosis and restrict access to susceptibility results needed for treatment selection.

Limitations:

• The study only covered seven states and Delhi, which may not represent the entire country.
• Access to laboratory tests varied significantly by region and facility type.

Conclusion:

Strengthening diagnostic access at peripheral health facilities could help achieve the goals of the National TB Elimination Program.

Sources:

• Microbiology Spectrum