Under NTEP (National Tuberculosis Elimination Programme), a patient with drug-sensitive TB who becomes sputum smear-positive at end of second month of intensive phase should be:

• A Declared treatment failure immediately
• B Started directly on Category II regimen
• C Extended intensive phase by one month and sputum sent for DST/culture ✓
• D Switched to XDR-TB regimen

Explanation

Under the revised NTEP (2019 guidelines), smear-positive at end of 2 months requires extension of the intensive phase by one month, with sputum sent for culture and drug susceptibility testing (DST). Category II (re-treatment) regimen is no longer used; NTEP now follows individual patient regimen based on DST results. Treatment failure is declared only if the patient remains smear-positive at month 5 or later, or if cultures grow resistant organisms.

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

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Written and medically reviewed by the StethoPrep medical team.