Under the National Tuberculosis Elimination Programme (NTEP), an adult presents with cough of 3 weeks and sputum is available. Which diagnostic test is currently recommended as the INITIAL step for all such presumptive pulmonary TB patients?

• A Two sputum smear examinations by Ziehl-Neelsen staining
• B Chest radiograph followed by culture if abnormal
• C Rapid molecular test such as CBNAAT or Truenat ✓
• D Tuberculin skin test before any bacteriological test

Explanation

NTEP moved to universal access to drug susceptibility testing by making rapid molecular testing (CBNAAT, later expanded to Truenat) the initial diagnostic test for every presumptive pulmonary TB patient with sputum available, rather than smear alone. This detects rifampicin resistance upfront. Smear microscopy remains useful where molecular platforms cannot be accessed, but it is no longer the mandated first step when NAAT is available, and tuberculin testing has no diagnostic role in adult active TB.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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