A 34-year-old man presents with cough of three weeks and weight loss. Sputum is collected and sent for testing under the National Tuberculosis Elimination Programme. According to current NTEP policy, what is the recommended FIRST diagnostic test for this patient?

• A Molecular assay such as CBNAAT/Truenat with reflex drug susceptibility testing ✓
• B Sputum smear microscopy by Ziehl-Neelsen stain
• C Chest radiograph followed by empirical antitubercular therapy
• D Sputum culture on Lowenstein-Jensen medium

Explanation

NTEP moved from microscopy-first to a molecular-first approach, offering upfront NAAT (CBNAAT/Truenat) to every presumptive TB patient as part of Universal Drug Susceptibility Testing. This detects rifampicin resistance at diagnosis, which microscopy cannot do. Culture remains the reference standard but takes weeks and is reserved for treatment failure, relapse, or resistance confirmation, so it is not the first test.

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.