Experience of “One Stop TB Diagnostic Solution” Model in Engaging a Private Laboratory for End-to-End Diagnostic Services in the National TB Elimination Program in Hisar, India
Rajesh Raju,
Banuru Muralidhara Prasad,
Umesh Alavadi,
Sanjeev Saini,
Mukesh Sabharwal,
Akshay Duhan,
Sridhar Anand,
Manohar Lal,
Harpreet Kaur,
Neerja Arora,
Jyoti Jaju,
Moe Moore,
Ranjani Ramachandran,
Nishant Kumar,
Rajendra P. Joshi
Affiliations
Rajesh Raju
Directorate of Health Services, Government of Haryana, Swasthya Bhavan, Sector 6, Panchkula 134109, India
Banuru Muralidhara Prasad
Infectious Disease Detection and Surveillance (IDDS), New Delhi 110058, India
Umesh Alavadi
United States Agency for International Development, New Delhi 110021, India
Sanjeev Saini
Infectious Disease Detection and Surveillance (IDDS), New Delhi 110058, India
Mukesh Sabharwal
Directorate of Health Services, Government of Haryana, Swasthya Bhavan, Sector 6, Panchkula 134109, India
Akshay Duhan
Directorate of Health Services, Government of Haryana, Swasthya Bhavan, Sector 6, Panchkula 134109, India
Sridhar Anand
TB Support Network, Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi 110021, India
Manohar Lal
Infectious Disease Detection and Surveillance (IDDS), New Delhi 110058, India
Harpreet Kaur
Infectious Disease Detection and Surveillance (IDDS), New Delhi 110058, India
Neerja Arora
iDEFEAT Project, IQVIA, New Delhi 110021, India
Jyoti Jaju
iDEFEAT Project, The International Union against Tuberculosis and Lung Disease (The Union), New Delhi 110016, India
Moe Moore
Infectious Disease Detection and Surveillance (IDDS), New Delhi 110058, India
Ranjani Ramachandran
Office of the World Health Organization (WHO) Representative to India, WHO Country Office, New Delhi 110021, India
Nishant Kumar
Central TB Division, Ministry of Health and Family Welfare Government of India, New Delhi 110001, India
Rajendra P. Joshi
Central TB Division, Ministry of Health and Family Welfare Government of India, New Delhi 110001, India
The complete diagnostic evaluation of tuberculosis based on its drug-resistance profile is critical for appropriate treatment decisions. The TB diagnostic landscape in India has been transformed with the scaling-up of WHO-recommended diagnostics, but challenges remain with specimen transportation, completing diagnostic assessment, turnaround time (TAT), and maintaining laboratories. Private laboratories have demonstrated efficiencies for specimen collection, transportation, and the timely testing and issue of results. A one-stop TB diagnostic model was designed to assess the feasibility of providing end-to-end diagnostic services in the Hisar district of Haryana state, India. A NTEP-certified private laboratory was engaged to provide the services, complementing the existing public sector diagnostic services. A total of 10,164 specimens were collected between May 2022 and January 2023 and these were followed for the complete diagnostic assessment of Drug-Susceptible TB (DS-TB) and Drug-Resistant TB (DR-TB) and the time taken for issuing results. A total of 2152 (21%) patients were detected with TB, 1996 (93%) Rifampicin-Sensitive and 134 (6%) with Rifampicin-Resistant TB. Nearly 99% of the patients completed the evaluation of DS-TB and DR-TB within the recommended TAT. The One-Stop TB/DR-TB Diagnostic Solution model has demonstrated that diagnostic efficiencies could be enhanced through the strategic purchase of private laboratory services.
