Dr Nitin Abhyankar, a chest physician and bronchoscopist of Pune, is working towards evolving a right diagnostic approach to treat TB patients with his five years project called-`Role of bronchoscopy in sputum smear negative pulmonary tuberculosis suspects'-at Poona Hospital and Research Centre in Pune.

Dwelling on the project, Dr Abhayankar said that it was started in the year 2002 and till date thirty-five pulmonary TB suspects with sputum smear negative status were subjected to diagnostic bronchoscopy in a prospective study. Bronchio alveolar lavage from disease segment, localised by radiological and endoscopic assistance, was carried out. Endobronchial biopsy and transbronchial lung biopsy was also done.

Currently, the most crucial problem the country faces in the area of TB treatment is the absence of a right diagnostic approach. Since this has emerged as an important issue in treating the disease, around 20-40per cent of the non-TB population exposed to TB treatment, are facing disastrous side effects of anti-TB drugs.

He further elaborated that the Val samples were further processed for gram stain, ZN stain, AFP culture (radiometric + conventional method) and PCR for TB and endobronchial biopsy and transbronchial lung biopsy. "The final conclusion showed that 12 out of 35 (35per cent) were positive for ZN smear test alone, 25 out of 35 (71per cent) were positive for PCR test, six out of 35(17 per cent) had growth on AFP culture and 10 out of 35 (29per cent) had showed TB with endobronchial biopsy and transbronchial lung biopsy. When the whole data was put together the overall diagnostic yield was 33 out of 35 that is 96per cent,'' confirmed Dr Abhyankar. The data would be further validated by negative control tests, averred he.

Commenting on the present diagnostic approach, he lamented that with the absence of the right diagnostic approach, the non-TB patients too, are exposed to anti-TB drugs leading to drastic side effects and in some cases even death. He noted that most of the clinicians carry out the tests in isolation and do not go further to prove the presence of TB germs in a patient.

"Sometimes it is seen that the doctor just rely on X-ray reports and suspecting it as a TB case they treat the patients for TB, which can be fatal for the patient," pointed out he. Commenting on the DOTS method he said though the method is beneficial in the treatment of TB, around 25-30per cent is covered by DOTS and roughly 10per cent of the potential cases are benefited by it. "To fulfill the target of wiping out 80-85per cent of TB from the country by 2010, it is necessary that DOTS is spread across the country in a uniform and methodical way,'' he opined.