After medicines, shortage of TB testing cartridges sparks concern

Mumbai: After tuberculosis (TB) drugs, the city’s TB office is now witnessing a shortage of cartridges for CBNAAT machines that are crucial to the early detection and treatment of the disease.

CBNAAT (cartridge-based nucleic acid amplification testing) is an automated cartridge-based molecular technique that detects multi-drug resistant TB (MDR-TB) and resistance to the first-line drug rifampicin within two hours.

Following the shortage, 24 district TB officers in Mumbai have been asked to follow a standard operating procedure (SOP) till the availability of the stock normalises.

“We have taken cognisance of the shortage of cartridges, following which we have held a series of meetings, one with the BMC commissioner last evening. SOP involves performing CBNAAT in wards with a high burden of TB cases. For wards with fewer TB cases, microscopic tests and X-rays have been advised. The SOP is for optimal usage of the available stock,” a district TB officer said.

Another officer said constant reviews and monitoring at all levels on the total cartridge stock and testing of patients has been undertaken.

“We have been facing a shortage of cartridges since last month. We have been asked to judicially use it till the new supply comes in. We have not been told when the new stock will arrive or the reason behind the delay,” said the official.

TB experts said the introduction of CBNAAT has helped in the rapid TB diagnosis in the city/state since 2015. Mumbai has 42 machines and expects three more in the coming days. Mumbai needs 12,000 to 15,000 cartridges per month. “We had a stock of 4,000 when the panic button was pressed. We got 1,000 cartridges via CSR and we managed the rest somehow,” another official said.

Ashrah Azmi, ex-corporator also wrote a letter on October 12 to the BMC commissioner Iqbal Singh Chahal, highlighting the cartridge shortage.

Ganesh Acharya, TB survivor and activist, said, “The technique helps in detecting TB in sputum samples with a low bacterial load, which often goes undetected under a microscope. It has helped improve detection rate, curb transmission and ensure faster access to treatment. With the shortage of CBNAAT, we are back to the traditional microscopic detection.”

Dr Varsha Puri, Mumbai TB officer, said they are procuring 10,000 cartridges from Bhopal, and BMC has also agreed to purchase them if needed.

“We have 7,500 cartridges at present, which have been distributed to all the ward offices. Apart from 10,000 cartridges from Bhopal, we also received permission from higher authorities in yesterday’s meeting to purchase cartridges. The state TB department has also assured that supply will be restored at the earliest since the technical glitch has been resolved,” said Puri.