Assessment of Molecular and Traditional Diagnostic Methods for Tuberculosis in Tribal Belt of Western India

Abstract

Tuberculosis (TB) remains a significant public health challenge in the tribal regions of Western India owing to limited healthcare infrastructure and resource constraints. This study evaluated the effectiveness of TB diagnostic techniques, including Ziehl-Neelsen (ZN) staining, the Cartridge-Based Nucleic Acid Amplification Test (CBNAAT), Truenat, culture testing, Xpert Ultra, and the Tuberculin Skin Test (TST). ZN staining showed limited sensitivity with a positivity rate of 1.63%. CBNAAT and Truenat demonstrated higher sensitivities, detecting 8.74% and 8.34% of the cases, respectively, making them more reliable for early detection. Culture testing, although the gold standard, had a lower positivity rate of 6.66% owing to its dependence on viable bacilli and longer processing times. Xpert Ultra detected multidrug-resistant TB (MDR-TB) and identified resistance to isoniazid (INH), fluoroquinolones (FLQ), and amikacin (AMK) in a subset of cases, highlighting the need for advanced molecular diagnostics to guide treatment. The TST showed a high prevalence of latent TB (58.69%), indicating widespread exposure in the tribal population. Demographic analysis revealed a higher prevalence of TB in males and older individuals. These findings emphasize the need for advanced molecular diagnostics, such as CBNAAT, Truenat, and Xpert Ultra, to improve TB detection and management in resource-limited settings. Expanding access to these tools is crucial for effective TB control and for achieving global elimination goals.