Need to communicate results to patient

It is important that patients receive their positive/negative test results and an adequate explanation of the results in a timely manner.

Time required for different Laboratory test results include:

1. Smear microscopy/follow up:1 day

2. Nucleic Acid Amplification Test (NAAT) (CBNAAT/Truenat):1-2 days

3. Line Probe Assay (LPA): 2-3 days

4. Liquid Culture DST (Drug Susceptibility testing): 22-48 days

Results of all laboratory tests such as smear, culture and DST / LPA / NAAT should be entered in Nikshay by the testing facility

Communicating test results

Communicating test results to the patient provides an opportunity to discuss about TB disease, its prognosis and treatment options.

It also includes counselling and educating patient and family members on need for regular treatment, cough etiquette and proper disposal of sputum to prevent transmission of disease.

It is important that:

• All results should be communicated to the concerned health facility through Nikshay as soon as results are available
• Alternative means (email, SMS etc) are also used to communicate the test results
• Test results once available, should be promptly communicated to the patients by NTEP supervisors/general health system staff/community volunteers within 1-2 days
  • It is essential that laboratory technicians record the complete addresses of patients examined for diagnosis. This facilitates tracing and initiation of treatment for all diagnosed TB cases
• All patients whose test report is positive should be provided information on TB disease, TB treatment and counselled for early treatment initiation. Emphasis should be made on starting the treatment at the earliest in order to prevent further transmission of disease .
  • The primary caregivers and other household members of the patient should be counselled for matters related to patient’s TB treatment, cough hygiene, risk of spreading infection, nutrition and also address issues related to gender, stigma, discrimination or any other psycho-social issues (if any, related to TB diagnosis) that could impact treatment initiation.
• For those patients whose test report is negative (active TB ruled out), they should be further tested for TB infection (TBI) and on confirmation of TBI, their eligibility for TB preventive treatment (TPT) should be assessed and necessary action should be taken, if eligible.
• For those patients who do not have TB disease nor TB infection, negative test result also needs to be communicated. Broad spectrum antibiotics are prescribed to them for 10-14 days. Most patients are likely to improve with a course of antibiotics if they are not suffering from TB.
  • If the symptoms persist after the course of antibiotics, the patient is re-evaluated by repeat sputum and X-ray examination and decision to treat accordingly is made by the treating physician.

Resources 

• Training Modules for Programme Managers and Medical Officers  
• Module for Senior Treatment Supervisor 
• Guidelines for PMDT in India, 2021 

Assessment