Transportation of Biological Specimens

All efforts must be made to have decentralized local arrangements for transporting the specimens to the Designated Microscopy Centre (DMC)/ Culture Drug Susceptibility Test (CDST) and molecular Nucleic Acid Amplification Test (NAAT) and Line probe assay (LPA) labs through human volunteers/courier/speed post. The specimens collected should be carefully packed in a box to avoid any spillage or contamination. 

The following points must be considered for the transportation of biological specimens: 

• Samples need to be transported to DMC or CDST laboratory within 72 hours (in a cold chain if sent to CDST and molecular laboratories)
• The health care worker must inform and coordinate with the sample transportation agency to transport the sample to the necessary laboratory
• The accompanying dispatch list present along with the biological specimen must tally with the total number of sputum specimens collected, and must specify the details of the referring health facility collecting the specimen
• The Specimen Identification Number on the specimen container and the accompanying dispatch list must match
• For each patient, one biological requisition form is required and all necessary details should be filled
• All specimens transported to the laboratory must be accompanied by the request form in hard and soft copy formats 
• Triple packing system should be utilized for transportation
• The box containing the specimen samples to be transported to the National TB Elimination Program (NTEP) certified laboratory should be labelled with a “BIO-HAZARD” sticker 
• The date of dispatch must be marked by the health worker on the dispatch list and the same must be attached outside the box containing the specimen 

Triple Layer Packaging 

As per NTEP guidelines, the sputum specimen is packaged in triple layers for transportation to avoid spills and leakage and pose no hazard to the transporter. This includes:

1. Primary Container: This is a watertight, leak-proof, unbreakable tube containing the specimen. The tube is packaged with enough absorbent material to absorb all fluid in case of breakage or leakage.

Figure 1: Primary container; Source: PMDT Guidelines, 2021

2. Secondary Packaging: This is watertight, leak-proof packaging to enclose and protect the primary container. Several primary containers may be placed in one secondary packaging.

Figure 2: Secondary Packaging; Source: PMDT Guidelines, 2021

3. Outer Packaging: Secondary packaging is placed in rigid outer packaging to protect the contents from physical damage during transport. Gel packs should be kept inside the box to maintain temperature along with suitable absorbent/ cushioning material

Figure 3: Outer Packaging; Source: PMDT Guidelines, 2021

The transporter needs to ensure the following:

1. The outer packaging is not damaged and is properly sealed
2. Biohazard label is pasted on the outer packaging 
3. “From” and “To” addresses are clearly labelled
4. Contact details (name, phone no.) of the receiver is pasted
5. Upright symbol () is pasted appropriately
6. The temperature is maintained at 2-8⁰ C for the entire transportation period 
7. Transport at the earliest (to reach the destination within 72 hours)

Resources

• Technical and Operational Guidelines for TB Control in India, 2016 
• PMDT Guidelines 2021

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