The issues to be addressed while establishing a tuberculosis culture laboratory are discussed in the paper. Primarily the following questions are to be considered: (1) Is it absolutely essential to have a tuberculosis culture laboratory? (2) Will it be big or small? (3) Are there adequate means to continue work in terms of finance, staff, equipment & specimens and (4) Is there a possibility of taking up any other type of bacteriological work, if necessary? Unlike other bacteriology laboratory, a tuberculosis laboratory has some unique features. Due to the slow growth of the organism, cultures need to be incubated for a long time i.e., 8 10 weeks. So an incubator room is required. More number of glassware are needed. Test tubes with cotton plugs are unsuitable as they are likely to dry up. Hence screw capped tubes or McCartney bottles are required to facilitate long incubation of cultures. For performing identification tests, incubators with varying temperatures, i.e., 23, 37, 44, are to be provided. Plenty of cold storage space is needed to stock cultures, media, etc.

The requirement of staff and organisation of work depends upon the number of specimens handled. If 50 specimens per day are likely to be processed, 5 lab technicians, 3 lab attendants, 1 sweeper and 1 bacteriologist are necessary. Once laboratory is opened, maximum benefit should be derived by getting adequate number of specimens.

This paper deals with the cost of establishing and running a bacteriological laboratory in State Tuberculosis Centres under the National Tuberculosis Programme, and the cost of various examinations to be undertaken in such a laboratory. A knowledge of the cost will enable proper planning and judicious utilization of the resources. Further, when services are rendered to private individuals or institutions, the charges for different examinations can be levied on a rational basis. The place of smear and culture examinations under the programme, the implications of establishing a culture laboratory, the limitations of cost worked out, have been discussed. A plan of the laboratory building is also provided.

The cost has been worked out presuming that about 12,000 specimens per year are likely to be received, of which 25% might turn out to be positives. Non recurring cost was estimated to be Rs.1,07,724 and annual recurring cost would be Rs.49,709. Factors that contribute to the cost structure are overheads, cost of material and labour. In addition, certain essential facilities like cold room, incubator room, gas supply, washing and sterilisation etc., add to the cost. (i) staff-bacteriologist-1, lab technicians-4, lab attendants-3 and registration clerk-1; their salaries, (ii) building-rent (iii) electricity (iv) furniture (v) equipment and supplies (vi) water charges had all been taken into consideration. The cost of one smear examination was estimated to be Rs.0.54 and that of culture and sensitivity test Rs.9.43.