Under NTEP, the Molecular Drug Susceptibility Testing (DST) algorithm mandates that all TB patients undergo testing for rifampicin resistance using CBNAAT/TrueNat at diagnosis. A patient tests rifampicin-resistant (RR-TB). The NEXT step as per current guidelines is:
- A Start Category II (2HRZES/1HRZE/5HRE) treatment immediately
- B Send sputum for Line Probe Assay (LPA) to check for isoniazid resistance and second-line DST ✓
- C Start Bedaquiline + Linezolid without further testing
- D Refer to district hospital for X-pert MTB/RIF Ultra testing
Correct answer: B. Send sputum for Line Probe Assay (LPA) to check for isoniazid resistance and second-line DST
Explanation
When a patient is diagnosed as RR-TB, the NTEP mandates upfront LPA (Line Probe Assay) for first-line (FL-LPA: isoniazid resistance testing) and second-line DST before finalizing the treatment regimen. This determines whether the patient has MDR-TB, pre-XDR-TB, or XDR-TB, guiding selection of the appropriate BPaLM/BPaL or shorter MDR-TB regimen. Category II is obsolete under NTEP.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.