Laboratory consumables

1. Cartridge-based Nucleic Acid Amplification Tests (CBNAAT) machines and Cartridges

• The CBNAAT machines and cartridges are procured by Central TB Division (CTD) and supplied to state/ district/ CBNAAT sites based on their requirement.
• Cartridges are supplied based on the stock availability, consumption and expected case load.
• Recording, reporting and monitoring of cartridges are done through Ni-kshay Aushadhi.

2. Binocular Microscope (BM) and LED Fluorescence microscopy (LED-FM)

• The procurement of both items is undertaken by CTD and then delivered to the states/ districts.
• All LED-FM/ BMs should be covered by annual maintenance contracts by states/districts, at the end of their warranty periods.
• NTEP guideline recommends 1 BM for every Designated Microscopy Centre (DMC) and LED FMs only for the high case load facilities with >25 slides per day.
• Along with public sector DMCs, NTEP may also supply BMs to DMCs established in other sectors like ESIS, Public Sector Undertakings, Medical College, etc., if required.

3. Sputum containers

Calculation of requirement of sputum containers:

For diagnosis:

• During the first week of each quarter, the number of new pulmonary smear-positive cases registered and treated during the last quarter in the district should be determined and this number should be multiplied by 10.
• 10 is the average number of symptomatic required to be examined for detecting one case of new pulmonary smear-positive tuberculosis and it includes all types of patients.
• Since two sputum specimens are taken for each symptomatic patient, further multiply the number obtained above by 2.
• The final number derived would be the required no. of slides for diagnosis.

For follow-up:

• Two follow-up specimens are taken for the majority of patients (one at the end of the intensive phase and the other at the end of treatment), therefore one sputum container is needed for each follow-up.
• On the last working day of the quarter, count the number of sputum containers in stock and subtract from the required number as calculated above.
• Allow sufficient reserve stock for three months, add 10% to account for wastage of sputum containers, and account for the sputum containers in stock.

4. Slides

• One slide is used to examine one specimen in a sputum container. Therefore, order a slightly higher number of slides, than the required no. of sputum containers to account for unavoidable breakage of slides.
• Order for both sputum containers and slides should be placed during the first week of the quarter.
• The supplies will be procured by the state/ district and supplied to all the peripheral health institutions in the district.