Under the NTEP, a patient who was previously treated for drug-susceptible TB and returns after defaulting (lost to follow-up >2 months) should be subjected to which diagnostic workup BEFORE re-initiating treatment?

• A Upfront drug susceptibility testing (DST) using CBNAAT/TrueNat or LPA ✓
• B Sputum smear microscopy alone
• C Chest X-ray and sputum culture only
• D Clinical assessment alone without laboratory testing

Explanation

NTEP mandates upfront DST for all previously treated TB patients (retreatment cases) including those returning after loss to follow-up. CBNAAT (Xpert MTB/RIF) or TrueNat is the preferred rapid molecular test to detect rifampicin resistance; line probe assay (LPA) can detect isoniazid and rifampicin resistance simultaneously. This prevents inadvertently re-treating drug-resistant TB with an inadequate regimen, which would amplify resistance. Smear microscopy alone is insufficient as it cannot detect drug resistance.

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.