<prompt> Screening under RNTCP emphasizes on:Sputum microscopyChest X-rayPCRSputum culture  <response>: Ans. a. Sputum microscopy Ref: Park 23e p427, 662, 22e p394Screening under RNTCP emphasizes on sputum microscopy.Over-reliance on chest X-ray was a draw back of National Tuberculosis Programme NTP, which was over come by Revised National Tuberculosis Control Programme RNTCP which started diagnosing patient by sputum microscopy.-Park 22e p394A nation-wide network of RNTCP quality assured designated sputum smear microscopy laboratories has been set up, providing appropriate, available, affordable and accessible diagnostic services for TB suspects and cases. These laboratories carry out sputum microscopy with External Quality Assessment EQA, and Drug Resistance Surveillance DRS related activities. Number of spec imens required for diagnosis of smear positive pulmonary Tuberculosis: TWO; Spot sputum specimen Day 1 and Morning sputum specimen Day 2. - Park 22e p394New Tuberculosis Diagnosis RNTCP Guidelines in IndiaObjectives:Achievement of at least 85 per cent cure rate of infectious cases of tuberculosis: through DOTS involving peripheral health functionariesAugmentation of case finding activities through quality sputum microscopy to detect at least 70 per cent of estimated cases.History of RNTCP:RNTCP based on DOTS strategy, began as a pilot in 1993 and was launched as a national program in 1997Rapid RNTCP expansion began in late 1998By 24th March 2006. the entire country was covered under DOTS, covering 1114 million peopleInfrastructure:The RNTCP designated Microscopy Centre is established for approx. 100,000 populationQ 50,000 in hilly and mountainous areasSenior TB Laboratory Supervisor STLSOne STLS for every 5 microscopy centersOne STLS per 5 lac populationQSTLS rechecks all ve slides and 10 of all --ve slidesDiagnosis in RNTCP:In RNTCP, mainstay of diagnosis is Sputum microscopy; the sputum smears are stained for acid fast Bacilli AFB with Ziehl Neelson ZN StainDecolorizer: 25 sulphuric acidCounter-stainQ; 0.1 Loeffier s methylene blue or 1 picric acid or 0.2 malachite green.Number of specimens required for diagnosis of smear positive pulmonary TB: TwoSpot sputum specimen Day 1Morning sputum specimen Day 2Tuberculosis Suspect: Any person with cough 2 weeks or moreDiagnosis of Tuberculosis:None sputum positive: DoubtfulOne sputum positive: Sputum positive pulmonary TBTwo sputum positive: Sputum positive pulmonary TBManagement of clients:None sputum positive: Give antibiotics for 10-14 daysCough relieved: Non- tuberculosis personCough persists: Repeat two sputum smear examinationsNone sputum positive: X-ray chestFindings suggestive of TB: Sputum negative TB; Start ATTNo findings suggestive of TB: Non- tuberculosis personOne sputum positive: Sputum positive pulmonary TB: Start ATTTwo sputum positive: Sputum positive pulmonary TB; Start ATTDifferences in National Tuberculosis Programme NTP and RNTCP NTP, 1962RNTCPObjective Early diagnosis and treatmentQ Breaking chain of transmissionQOperational targets Not definedQ Cure rate 85Q Case finding 70QStrategy SCC supervisedQ ConventionalQ DOTSQ Uninterrupted drug supplyQDiagnosis More emphasis on X-raysQ Mainly sputum microscopyQ 