The NTEP 4-drug Fixed Dose Combination (4FDC) regimen for new adult TB patients (weight band 55–70 kg) during the intensive phase includes Isoniazid 75 mg, Rifampicin 150 mg, Pyrazinamide 400 mg, and Ethambutol 275 mg. Which of the following statements about NTEP's current drug-susceptibility testing (DST) strategy is MOST accurate?
- A Universal DST (UDST) is recommended for all bacteriologically-confirmed TB patients at diagnosis ✓
- B DST is performed only after treatment failure at 2 months
- C Cartridge-based nucleic acid amplification test (CBNAAT) is reserved for MDR-TB suspects only
- D Line probe assay (LPA) is used as first-line test for smear-positive patients to detect isoniazid resistance only
Correct answer: A. Universal DST (UDST) is recommended for all bacteriologically-confirmed TB patients at diagnosis
Explanation
The current NTEP strategy mandates Universal Drug Sensitivity Testing (UDST) for all bacteriologically-confirmed TB patients at the time of diagnosis before starting treatment. This upfront DST strategy uses rapid molecular tests (CBNAAT/TrueNat/LPA) to detect rifampicin and isoniazid resistance early, enabling timely initiation of appropriate regimens. Earlier approaches reserved DST for re-treatment or failure cases, which led to amplification of resistance. LPA detects both rifampicin and isoniazid resistance, not isoniazid alone.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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