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Mini Review Volume 13 Issue 1
Sustainable interventions for improvement in external quality assurance (EQA) of Truenat MTB/RIF, Telangana State, India
S chittiboyina, Sk Shanmugam, A Rajesham, S Shukla, S Bhanu Kiran, V Gumma, S Bhargava
Received: March 25, 2026 | Published: April 1, 2026
Citation: chittiboyina S, Shanmugam SK, Rajesham A, et al. Sustainable interventions for improvement in external quality assurance (EQA) of Truenat MTB/RIF, Telangana State, India. J Lung Pulm Respir Re. 2026;13(1):19-22. DOI: 10.15406/jlprr.2026.13.00339
Abstract
Background and challenges to implementation : National TB Elimination program (NTEP) in India has rapidly scaled up Truenat MTB/RIF testing as upfront molecular testing for TB diagnosis. External Quality Assurance (EQA) is a key step especially when new Nucleic Acid Amplification Test (NAAT) being offered. NTEP has developed EQA program by using CDC’s dried tube technology for NAAT and evaluated for a score of 100. Score more than 80 is considered satisfactory while score less than 80 as unsatisfactory. Telangana State recorded poor EQA for Truenat Program in 2021 and 2022. Key challenges are frequent changes of staff at field level, equipment maintenance, limitation of knowledge and training for lab staff, inadequate site Monitoring visits. Intervention or response: Communication mechanism was established whenever there was change in the staff operating Truenat machines. Post EQA visits were conducted for poor performing sites and the root cause analysis (RCA) was done. Based on the RCA corrective action and recommendations were given to the sites and implementation was monitored. Refresher training was conducted for all laboratory supervisors and technicians in 2022. Monthly virtual sessions were conducted for regular monitoring. Established data cell for analysis of monthly quality indicators and presented in virtual sessions to the sites. The State developed internal Quality checklist for continuous monitoring. Close coordination with the respective equipment vendors was maintained to resolve site wise issues. Results/Impact: Stepwise improvement recorded for EQA performance from 2021 to 2023 in the following figure below Conclusions: Telangana state of India has showed a significant improvement in all parameters of EQA in Truenat testing by implementing effective monitoring mechanism.
Keywords: External quality assurance, sustainable interventions, Truenat MTB rif assay
©2026 chittiboyina, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.