Designated Microscopy Centre [DMC]

Sputum microscopy diagnostic services under the National TB Elimination Programme (NTEP) are provided by the Designated Microscopy Centres (DMCs) established at the Peripheral Health Institution (PHI) level, where a functional binocular microscope and a trained Laboratory Technician (LT) is available. Light Emission Diode Fluorescent microscopes are provided to high-load PHI-DMCs such as that of the medical colleges. 

Based on latest directives, a DMCs may be established at all PHIs (Public and Private) of the country as needed. It is mandatory to have a DMC at all medical colleges in the country.

As molecular technologies like Truenat are also used in DMCs, NTEP has planned to rename DMCs as TB Diagnosis Centres (TDCs).

Criteria to be a DMC

The DMCs should satisfy the following criteria:

1. NTEP-trained Laboratory Technician (LT) should be present.
2. A functional binocular microscope should be present in the laboratory.
3. Physical infrastructure in the laboratory should meet NTEP guidelines.
4. Daily new adult outpatient cases of at least 60-100 and/or workload of at least 3-5 sputum smears per day for the LT in the laboratory.

DMCs in the public sector, at the onset of the programme, are provided with funds to undertake minor civil works to build up their physical infrastructure and are provided with binocular microscopes.

Human Resources Norms

• For the purpose of NTEP, a PHI is a health facility which is manned by at least a Medical Officer (MO).
• In addition to the MO and LT, there is 1 TB Health Visitor (TBHV) per one lakh urban population to support the urban TB prevention and cure activities.

Other Criteria

Microscopy Centres may be established beyond population norms in medical colleges, corporate hospitals, Employee State Insurance Corporation (ESIC), railways, Non-government organisations (NGOs), private hospitals, Ayushman Bharat - Health and Wellness Centres (AB-HWCs), etc.

Before designating a DMC in other sectors, there should be a formal agreement by the hospital/ laboratory to take part in the External Quality Assurance (EQA) and to allow the concerned NTEP staff to supervise as per the NTEP guidelines.

If the above criteria are met by any private laboratory, the lab is considered for establishing a DMC.

• To provide better access for diagnosis of TB, all PHIs, wherever LTs and binocular microscopes are available, can be upgraded to a DMC irrespective of the population norms or OPD attendance.
• All DMCs should comply with the Quality Assurance (QA) mechanisms as per the EQA guidelines.

Resources

• NTEP Training Modules 1-4 for Programme Managers & Medical Officers, 2020.
• Operational Guidelines for TB Services at Ayushman Bharat Health and Wellness Centres.

Assessment Questions

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