Challenges in Laboratory Systems and Diagnosis

Laboratory systems and diagnosis pose several challenges in streamlining and upscaling as follows:

• Suboptimal Specimen Collection and Transportation (SCT) for diagnosis
• Ensuring last mile access to quality diagnostics for the presumptive TB cases in the remote corners of the country
• Diagnostic coverage for patients availing services from the private sector remains a challenge
• Nucleic Acid Amplification Test/ other modern diagnostics facilities in the private sector yet to be completely harnessed by the program
• Lack of review of laboratory work loads, network optimization and technology landscaping  
• Non-availability and/or underutilization of X-ray facilities at periphery adversely affects screening as well as diagnosis
• Turnaround Time (TAT) from TB/ drug-resistant TB diagnosis to test result reporting are at times delayed (high sample loads and improper interpretation and application of the prescribed diagnostic algorithm)
• Continued potential for compromised biosafety within the TB laboratory network is another key area of concern (space constraints, delays in maintenance of TB containment unit and timely procurement of spare parts)
• Rapid expansion of the lab network leading to sub-optimal supervision and monitoring for quality assurance, especially at peripheral level
• Retention of skilled human resource and requirement of additional work force is a major challenge.

Resources

• National Strategic Plan to End TB in India 2020-25 v6 26.05.2020 (Draft Copy).

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