Module 1: Introduction:  Dr Shubhi from Medical Learning Hub welcomed all participants and the speakers. She introduced the speakers and shared the flow of the event. All the general instructions were explained and the first poll was raised.

Module 2: Message from Cepheid leadership team: Mr. Dhiraj Sood  Mr Sood welcomed all the participants. He shared the statistics of TB globally and in India & explained the importance of eliminating TB in India. 

Module 3: Message from Lal Pathlabs: Dr. Monica Prabhakar  Dr Prabhakar thanked all the participants who are contributing to TB elimination. She explained the burden of TB in India. She also shared statistics of TB cases in India. She explained the diagnostic market in India for diagnosis of TB. She described the key facilities available by Lalpath labs and shared the organization values.

Module 4: The evolving landscape of TB laboratory diagnosis by Dr. Shalabh Malik

Dr Malik explained about evolving landscape of TB lab diagnosis, he shared detailed insights on following points: 

• The burden of TB globally and in India. 
• Latest statistics of diagnostic tests performed by the laboratory network by 2022.
• The development of more accurate diagnostic techniques.
• Two types of drug resistant detection are there. One is genotypic and another is phenotype.
• Genotypic cannot be used for determining the response to the treatment nor the efficacy of the treatment.
• First and second line of treatment.
• Definition of pre XDR and updated definition of XDR-TB
• Change in classification of anti TB drugs - second line drug regimen 
• Latest inclusion in national TB elimination program
• Diversification of molecular testing
• Examples of biomarkers for TB like IGRA, NAAT, CRP etc
• Novel samples types for molecular TB detection
• Enabling community-based TB testing
• Stool PCR testing - a novel sample type in children
• Explanation of Karius test: A CLIA-certified cfDNA assay
• Limitation  of Xpert MDR/XDR limitationTB testing algorithm in India. 

Module 5: New Horizon in drug resistant TB diagnosis: Dr Bornali Datta 

Dr Bornali Datta  presented on, New horizon of DR-TB diagnosis along with the latest updates on guidelines by WHO. She also described the few studies conducted in India. The highlights of her session are as follows.

• Early diagnosis and prompt treatment of TB is a need of the current times.
• Global burden of TB in 2020. Accessibility drug susceptibility tests are critical.
• Updated guidelines of operational handbook on TB.
• It recommends that all TB patients, non-responders, and everybody undergo an upfront NAAT.
• Example of study done in Karnataka: sample reaching and completing the diagnostic at Xpert lab
• Comparison of timings of results and difference between Xpert MTB/RIF, Xpert MTB/RIF ultra and Xpert MTB/XDR
• Intended use of the Xpert MTB/XDR: reflex test for a specimen that is determined to be MTB positive.
• The Xpert MTB/XDR assay demonstrated an equivalent limit of detection of Xpert MTB/RIF.
• Example of study conducted on Xpert MTB/XDR tests evaluated in real world setting to assess usefulness, diagnostics accuracy and operational aspects. 
• Benefits and limitations of Xpert MTB/XDR
• The patient pathway of drug resistance TB in India.

Module 6: Lymph node TB: A Clinician's perspective- Dr Mahesh Jansari 

Dr Jansari explained about Lymph node TB from clinician’s perspective, he briefly shared in detail about LNTB management along with the clinical case presentation. Following points were covered during his presentation: 

• Basic understanding of lymphadenopathy 
• Classification of lymphadenopathy 
• Red flag signs of LNTB
• A clinical approach should be while dealing with a case of lymphadenopathy
• Pathogenesis of LNTB
• Recommendation from Index TB guidelines
• Different studies conducted on TB/DRTB diagnostics
• The treatment protocol of TBLNP
• Principles of managing tubercular abscess
• Example of a randomized control trial conducted in Bangladesh in 2021 about the using of steroids
• Clinical presentation of lymphadenopathy.

Module 7: Management of DRTB: the way forward 

The Speaker's session was followed by panel discussion by Dr. Shalabh Malik, Dr. Kokila Banerjee, Dr. Mallika Ghosh, Dr. Prasanta Kumar Das, Dr.Ansuman Mukhopadhyay, Dr. Shelley Sharma Ganguly, Dr.Sanjib Bandyopadhyay. The session was moderated by Dr. Subhranshu Mandal.

Following points were  discussed during panel discussion: 

• Views on decentralizing DRTB management
• Current gaps in overall management of DRTB patients and how to mitigate them
• What are the bigger risks of undiagnosed or misdiagnosed cases of DRTB at both healthcare and the community level?
• What are the challenges in India in diagnosis of DRTB and how to mitigate them
• Expert views on 10 color technology and how it will make difference in multiplexing more targets and helping to diagnose more complex disease per se
• Expert view on compliance to second line drugs 
• How does the point of care approach for DRTB should be adopted by the government of India and new technologies to be part of TB management algorithm 
• The session was very interactive, a few questions asked from the participants which were answered by the experts post panel discussion.

Module 8: Vote of thanks:  Ms. Megha from Cepheid India delivered a vote of thanks to all the participants. The post poll was raised.

We wish you a great learning experience!!! 

This event was supported by Cepheid.