Under the National Tuberculosis Elimination Programme, which test has replaced sputum microscopy as the initial diagnostic test for all presumptive pulmonary tuberculosis patients, because it simultaneously detects the organism and resistance to a first-line drug?

• A Line probe assay (Genotype MTBDRplus)
• B Tuberculin skin test
• C Liquid culture with MGIT
• D Xpert MTB/RIF (CBNAAT) ✓

Explanation

Since 2018, NTEP recommends upfront universal Xpert MTB/RIF (CBNAAT) testing of all presumptive pulmonary and selected extrapulmonary TB cases. It gives results in about two hours and reports rifampicin resistance directly, enabling immediate placement on appropriate therapy. Line probe assay is used on culture isolates or smear-positive specimens for second-line workup, culture remains the gold standard but is slow, and the tuberculin skin test has no diagnostic role in adult pulmonary TB in India.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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