Before TB Testing, First Understand the Types of TB Testing and Estimated Costs

Coughing for more than two weeks, cold sweats at night even though the AC isn't on, weight loss for no apparent reason, if this combination feels familiar, don't rush to panic, but also don't ignore it. It could be a symptomTuberculosis (TB), an infectious disease caused by bacteriaMycobacterium tuberculosis.

Many people think that TB only attacks the lungs. In fact, these bacteria can "stop" into almost all organs of the body, except hair, nails and teeth. Therefore, the types of TB examinations vary, depending on the suspected organ and the purpose of the examination (diagnosing active TB or simply screening). Before going to the hospital or health center, let's get to know the types of tests first, so you don't get surprised about the procedures or costs.

1. Rapid Molecular Test (TCM)

You could say this is the "prima donna" of TB testing. Once the doctor suspects active TB symptoms, TCM is usually the first choice. The samples were taken fromsputum, so you will be asked to cough and expel phlegm into a special pot.

TCM is recommended directly by WHO and the Indonesian Ministry of Health because of its high accuracy, approx85–95%, and the results came out pretty quickly, just in2–3 hours.

2. Mantoux (Tuberculin) Test

Often called the tuberculin test, this is a test commonly performed onchildren, although adults can also undergo it for latent TB detection or initial screening. The method is to inject a special fluid under the skin of the arm, then the results are read afterwards48–72 hours.

Important note: this testcan't stand alone. Positive results still need to be confirmed with other supporting examinations before someone is declared positive for TB.

(The complete procedure can be seen in the STPI video: Part 1 and Part 2)

3. IGRA (Interferon Gamma Release Assay)

If you are more comfortable having blood drawn rather than having an injection in the skin or being asked to produce phlegm, IGRA could be an option. This test uses a samplebloodand the results came out deep24–48 hours.

Just like Mantoux, IGRA cannot make a diagnosis of active TB alone, its function is more directedscreening, to see a person's potential for exposure to TB bacteria.

4. X-ray (X-Ray)

Apart from TCM, chest x-rays are another mainstay weapon for detecting TB, especially for screening. Although it most often examines the lungs, X-rays can also be directed at other organs as the doctor suspects, for example the leg bones or spine. The results usually come out deep24–48 hours, and still needs to be supported by other tests to confirm the diagnosis.

5. Bacteriological Test (Sputum Culture)

This is the "old man" of the TB test, it was used long before TCM was popular. The sample is the same as phlegm, but it is cultured first in special media to ensure the presence or absence of bacteria. The process is longer,3–7 days, but has advantages: it can detect whether TB bacteria are presentdrug resistantor not.

6. CT Scan and MRI

For TB cases that attack organs outside the lungs (calledExtra pulmonary TB), for example in the head or other organs, CT Scan and MRI play a role in confirming the location and severity of the infection. The results are generally available in24–48 hours.

*Examinations carried out at private clinics or hospitals

The types of tests above are examinations carried out at private health facilities or those that are not integrated with government programs. All the tests mentioned are availableFREEif carried out at government health facilities or those that collaborate with the government, such as community health centers and regional general hospitals.

TB treatment

Generally TB treatment is carried out for a minimum of 6 months. However, it can be extended up to 9 months if it does not show negative results. But for drug-resistant TB, treatment can take up to 24 months. The cost of pulmonary TB treatment is borne by the government orFREEif treatment is carried out at government health facilities, such as community health centers and hospitals.

The most important point:all the tests aboveFREEif carried out at government health facilities or those that collaborate with the government, such as community health centers and referral hospitals. So, the fees above only apply if you choose the private route.

How to test for TB?

1. Via private health facilities: just come and ask for a TB test directly.
2. Via government health facilities: starting from the nearest community health center. If the symptoms point to TB, the doctor will refer for a sputum test (TCM or culture, depending on equipment availability). If additional examinations such as X-rays are needed, they will usually be referred to the hospital because community health centers generally do not have their own X-ray equipment.

Regarding Treatment, Don't Worry About the Cost

Standard TB treatment lasts a minimum of 6 months, can be extended to 9 months if the results are not negative. For cases of drug-resistant TB, treatment can take up to 24 months.

The good news is that all costs for pulmonary TB treatment are borne by the government, meaning it is free, as long as it is carried out at government health facilities such as community health centers and government referral hospitals.