Under RNTCP, sputum smear microscopy for Acid-Fast Bacilli (AFB) was the primary and most widely available initial diagnostic tool for presumptive pulmonary TB cases, especially at the peripheral health facility level due to its cost-effectiveness and ease of implementation. While GeneXpert and culture offer higher sensitivity and drug susceptibility information, their availability was initially limited to higher centers. Chest X-ray is a supportive tool but not definitive for diagnosis.
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