Pattern of Usage of TB Diagnostic Procedures in Private Sector across Three Cities of a Central Indian State

摘要

Despite the preference of Revised National Tuberculosis Control Program (RNTCP) for sputum microscopy, a variety of Tuberclosis (TB) diagnostic procedures are being used in private sector for the diagnosis of TB.Aim: To understand the pattern of usage of TB diagnostic procedures in private sector in one of the central Indian states.Materials and Methods: Seven months (June 2016 to December 2016) data were collected from selected leading laboratories across three cities of Chhattisgarh that included 6, 6 and 3 labs in Bilaspur, Durg & Bhilai and Rajnandgoan respectively.Results: Different diagnostic tests such as; Adenosine Deaminase (ADA), Fine Needle Aspiration Cytology (FNAC), Abdominal Ultra Sonography (USG), Chest X-ray (CXR), Immunoglobulin M (IGM) and serological tests such as TB Gold were found to be practiced in these cities without a definite pattern. Similarly of all the tests 9.4%, 13.4%, 46.7% and 30.3% (n=3295) were serological tests, sputum microscopy, CXR and other tests respectively across all the cities.Conclusion: Despite Government of India?s gazette to stop malpractice in TB diagnosis serological tests are rampantly happening across the three cities. Systematic reviews carried out on the commercial serological tests reveal that the results are inconsistent and of low quality. Furthermore, none of the international guidelines support the use of serological tests for the diagnosis of active TB. In addition, in one city over reliance on CXR was found which many a time is believed to be the major fuelling factor for irrational therapy and DR-TB. During the seven months period not even a single test of sputum microscopy has been carried out in the same city. Cooperation of private sector for TB care and control in needed in India and is also the vision of National Strategic Plan (NSP) however the same is only possible if the sector stops malpractice and adheres to standard guidelines.