The Complete TB Testing Cascade for Nepal.
From latent infection screening to drug-resistance confirmation. JHS Analytic Traders supplies the full tuberculosis diagnostic ladder used by Nepal's hospitals, reference labs, and government health programmes — covering every stage of TB management from contact tracing to MDR-TB treatment selection.
Tuberculosis remains one of Nepal's most significant public health challenges. The World Health Organization estimates Nepal records around 70,000 incident TB cases annually, with a notable proportion of multidrug-resistant TB (MDR-TB) and a long pipeline of contacts and healthcare workers requiring screening for latent TB infection (LTBI). Diagnosing TB accurately — at the right stage, with the right test, in the right lab tier — is what separates effective TB control from chronic transmission.
The modern TB diagnostic workflow has three clinically distinct stages: latent infection screening (asymptomatic individuals with TB exposure), active TB confirmation (symptomatic patients with cough, fever, weight loss), and drug resistance characterization (positive cases requiring treatment regimen selection). Each stage uses different sample types, different platforms, and serves different clinical questions. Equipping a Nepali hospital or reference lab to handle TB cases competently means having capability across all three.
JHS Analytic Traders' lead TB diagnostic platform is QIAGEN QuantiFERON-TB Gold Plus — the WHO-endorsed IGRA blood test for latent tuberculosis infection — for which JHS is the authorized distributor in Nepal. Active TB molecular detection and drug-resistance testing platforms are configured project-by-project from established global manufacturers, matched to the lab's tier, throughput, and accreditation target. Together these capabilities support the full TB diagnostic cascade for hospitals, reference labs, and government health programmes across Nepal.
Three Stages, Three Platforms, One Workflow
Latent TB Infection (LTBI) Screening
Who: Asymptomatic individuals — healthcare workers, household contacts of TB cases, immigration medicals, immunocompromised patients, pre-transplant workup. Sample: Whole blood. Platform: IGRA (interferon-gamma release assay), specifically QuantiFERON-TB Gold Plus. Turnaround: 24 hours from collection.
Active TB Diagnosis (Molecular Detection)
Who: Symptomatic patients with suspected pulmonary or extrapulmonary TB. Sample: Sputum, BAL, tissue, CSF, or other clinical specimens. Platform: Real-time PCR — molecular detection of Mycobacterium tuberculosis DNA on standard rt-PCR thermocyclers. Turnaround: Same day from sample receipt. Platform configured per lab on request.
Drug Resistance Characterization
Who: All confirmed TB cases (per WHO recommendation), prioritized for previously treated cases, contacts of MDR-TB cases, and treatment failures. Sample: Smear-positive sputum or culture isolate. Platform: Line probe assay (LPA) for first-line resistance (rifampicin and isoniazid — the markers that define MDR-TB) and second-line resistance (fluoroquinolones and aminoglycosides — relevant for XDR-TB diagnosis). Turnaround: 5–6 hours. Platform configured per lab on request.
QuantiFERON-TB Gold Plus — Authorized in Nepal
Flagship
QuantiFERON-TB Gold Plus
The WHO-recognised IGRA blood test for latent TB. Single visit, 24-hour turnaround. Unaffected by BCG vaccination.
Active TB Detection & Drug Resistance Testing — Configured on Request
For active TB molecular detection (real-time PCR for M. tuberculosis in sputum, BAL, tissue) and drug-resistance characterization (line probe assays for first- and second-line resistance), JHS sources tier-appropriate platforms from established global manufacturers and configures them to the lab's throughput, sample mix, and accreditation target. Tell us your project context — district hospital, provincial reference lab, NTRL, INGO-funded TB project, or private hospital network — and we'll specify the right combination of platform, reagents, and supporting infrastructure.
Portable Molecular Platforms with TB Capability
For district hospitals, primary care clinics, and outreach programmes where sample transport to a reference lab is not practical, JHS supplies portable cartridge-based real-time PCR platforms that include MTB / MTB+NTM detection as part of a broader multi-pathogen menu (HPV, respiratory, STI, GI). These are not WHO-prequalified TB-specific platforms — they are decentralized molecular workhorses that also support TB testing in non-accredited / triage settings.
For accredited TB labs and National TB Programme procurement, the WHO-endorsed platforms above remain the primary recommendation.
View Portable PCR Platforms (Molecular Diagnostics) →Which TB Test for Which Clinical Scenario
| IGRA (Latent) | Real-Time PCR (Active) | Line Probe Assay (DST) | |
|---|---|---|---|
| Clinical question answered | Has the patient been infected with TB? | Is active TB present in this sample? | Is the TB strain drug-resistant? |
| Patient type | Asymptomatic, screening | Symptomatic, suspected TB | Confirmed TB cases |
| Sample | Whole blood | Sputum, BAL, tissue, CSF | Smear-positive sputum or culture |
| Method | Interferon-gamma release assay (ELISA) | Real-time PCR amplification | Reverse hybridization line probe |
| Distinguishes latent vs. active? | No (positive in both) | Detects active disease | Not designed for this |
| Affected by BCG? | No (uses ESAT-6/CFP-10) | No (detects MTB DNA) | No (detects resistance genes) |
| Turnaround | 24 hours | Same day | 5–6 hours |
| Typical lab tier | Hospital lab with ELISA capability | Reference lab with rt-PCR | Reference lab with hybridization workflow |
What Else You'll Need to Run These Tests
Each TB diagnostic platform requires standard supporting lab infrastructure. JHS supplies the complete chain alongside the diagnostic kits — so a hospital or reference lab building TB testing capability can source a single integrated solution.
TB Diagnostics Is Part of JHS's Broader Clinical Diagnostics Portfolio.
Beyond TB, JHS Analytic Traders supplies hospital and reference lab equipment across infectious disease, immunology, hematology, biochemistry, and molecular diagnostics. Whether you're configuring a new lab, expanding TB testing capacity, or upgrading a National TB Programme reference lab, we'll specify the right combination of platforms, reagents, and supporting infrastructure for your throughput and accreditation needs.
What TB tests does JHS supply in Nepal?
JHS Analytic Traders supplies QIAGEN QuantiFERON-TB Gold Plus — the WHO-endorsed IGRA blood test for latent tuberculosis infection — as the authorized QIAGEN distributor in Nepal. For active TB molecular detection and drug-resistance testing, JHS sources tier-appropriate platforms from established global manufacturers on request, configured for the lab's throughput, sample volume, and accreditation requirements.
Which TB test should be used for which patient?
Latent TB infection screening uses QuantiFERON-TB Gold Plus IGRA — for asymptomatic individuals with TB exposure (healthcare workers, contacts of cases, immigration medicals, immunocompromised patients). Active TB diagnosis in symptomatic patients uses smear microscopy, real-time PCR, or rapid molecular assays on sputum, BAL, or tissue samples. Drug resistance testing using line probe assays is performed on culture-positive isolates or smear-positive sputum to identify rifampicin, isoniazid, and second-line drug resistance — essential for MDR-TB and XDR-TB management.
Why does Nepal need a structured TB diagnostic cascade?
Nepal's TB context is shaped by three factors: (1) near-universal BCG vaccination, which makes TST/Mantoux unreliable for latent TB screening — IGRA is the recommended alternative; (2) high TB burden combined with rising MDR-TB rates, which requires both rapid active-TB diagnosis and routine drug resistance testing; (3) decentralized lab capacity, where district hospitals and reference labs need different tier-appropriate platforms. A structured cascade — latent screening, active confirmation, and drug-resistance characterization — is what effective TB control actually requires.
Can JHS configure a complete TB testing lab?
Yes. For National TB Programme reference labs, INGO-funded TB projects, hospital networks, and academic teaching labs, JHS configures complete TB testing solutions — combining diagnostic kits, instruments, supporting lab equipment (incubators, PCR thermocyclers, ELISA readers, biosafety cabinets), validation documentation, training, and ongoing supply continuity under a single supplier accountability chain. Contact us to scope your full requirement.
Building or upgrading TB testing capacity?
Our technical desk advises on platform selection, sample workflow, and tier-appropriate sourcing for district hospitals, reference labs, and National TB Programme facilities — leading with the QIAGEN QFT-Plus platform for which we are authorized in Nepal, and configuring active TB and drug-resistance platforms project-by-project.
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