Screening In India Research Articles

Female cancer screening in India: Results from the National Family Health Survey (NFHS-5) and the way forward

ABSTRACT The incidence of cancer is increasing in India, reflecting global trends. This study attempts to identify various socioeconomic factors associated with breast and cervical cancer screening in females aged 30-49 years using the National Family Health Survey-5 (NFHS-5) data. Data focused on sociodemographic variables, cancer awareness, and information on breast and cervical cancer screening. Poisson regression was used to identify factors and reported adjusted prevalence ratio (APR) and 95% confidence intervals (CI). The proportion of women who had undergone breast and cervical cancer screening all over India was 0.9% and 1.9%, respectively. Socioeconomic factors seem to play a role as the poor and middle wealth index groups were less likely to undertake breast (APR = 0.60; 95%CI: 0.37, 0.99) and cervical cancer (APR = 0.68; 95%CI: 0.51, 0.92) screening compared to the wealthier groups. Moreover, 43% of participants in the poor wealth index category had not undergone cervical cancer screening (APR = 0.57; 95%CI: 0.33, 0.96). Further, women who watched messages on visual media were more likely to undergo screening for breast (APR = 2.00; 95%CI: 1.12, 3.57) and cervical cancer (APR = 1.46; 95%CI: 1.18, 1.82) within a week. In conclusion, screening for cancer among Indian females is remarkably low, which highlights the need for a uniform protocol for message dissemination on cancer and to collect information based on risk assessment. Furthermore, the negligible community participation in cancer screening points to the potential role of sociodemographic characteristics in taking up cancer screening, which was reflected in less participation among socioeconomically disadvantaged groups.

Cost-effectiveness of portable-automated ABR for universal neonatal hearing screening in India.

The World Health Organization considers Universal Neonatal Hearing Screening (UNHS) essential to global public health. Rashtriya Bal Swasthya Karyakram has included newborn hearing screening in India since 2013. The program faces human, infrastructure, and equipment shortages. First-line hearing screening with improved diagnostic accuracy is needed. The Portable Automated Auditory Brainstem Responses (P-AABR) can be used in remote areas for UNHS due to its low infrastructure needs and diagnostic accuracy. This study evaluated the cost-effectiveness of P-AABR in UNHS. We employed an analytical model based on decision trees to assess the cost-effectiveness of Otoacoustic Emission (OAE) and P-AABR. The total cost to the health system for P-AABR, regardless of true positive cases, is INR 10,535,915, while OAE costs INR 7,256,198. P-AABR detects 262 cases, whereas OAE detects 26 cases. Portable Automated ABR costs INR 97 per case detection, while OAE costs INR 67. The final ICER was 97407.69. The P-AABR device is cost-effective, safe and feasible for UNHS Rashtriya Bal Swasthya Karyakram (RBSK) programs. Beyond reducing false referrals and parent indirect costs, it detects more hearing-impaired infants. Even in shortages of skilled workers, existing staff can be trained. Thus, this study suggests integrating this device into community and primary health centers to expand UNHS coverage.

Case Series on Inborn Errors of Metabolism in Neonates: Highlighting the Need for Newborn Screening in India

Case Series on Inborn Errors of Metabolism in Neonates: Highlighting the Need for Newborn Screening in India

Autism Screening in India: Many a Chasm to Bridge

Autism Screening in India: Many a Chasm to Bridge

Diabetic retinopathy screening guidelines for Physicians in India: position statement by the Research Society for the Study of Diabetes in India (RSSDI) and the Vitreoretinal Society of India (VRSI)-2023

Diabetic retinopathy (DR) is a leading cause of blindness among working-age adults worldwide. India is the diabetes capital of the world and one in five adults is said to have diabetes in India. With the increase in diabetes, there is an increasing burden of diabetic retinopathy (DR). All patients with diabetes have a risk of losing vision due to DR. The prevalence of diabetic retinopathy is 12.5%; out of which, 4% are said to have vision-threatening diabetic retinopathy (VTDR) The early stages of DR are symptomless, necessitating a proactive screening for an early detection of DR in all people with diabetes before they develop VTDR. This is a position statement jointly developed by RSSDI (Research Society for the Study of Diabetes in India) and VRSI (Vitreo Retinal Society of India) to provide guidelines for Physicians on DR screening in India. These guidelines emphasize the need for regular DR screening of all people with diabetes. It is recommended that the Physicians establish an effective DR screening model in their clinics, eg., a non-mydriatic fundus camera utilizing artificial intelligence (AI) algorithms for fundus photography to identify referral or non-referral DR. This will facilitate early detection and timely referral to an ophthalmologist thereby preventing VTDR. The need to create public awareness regarding blindness due to DR and a collaboration between Physicians and ophthalmologists for the management of diabetes, opportunistic screening of DR, and timely management of DR may play a crucial role in decreasing the burden of blindness secondary to diabetes.

Cost-utility analysis of primary HPV testing through home-based self-sampling in comparison to visual inspection using acetic acid for cervical cancer screening in East district, Sikkim, India, 2023.

Primary Human Papilloma Virus (HPV) testing offers higher sensitivity and specificity over Visual Inspection using Acetic acid (VIA) in cervical cancer screening. Self-sampling is a promising strategy to boost participation and reduce disparities. However, concerns about the initial costs hinder HPV testing adoption in low and middle-income countries. This study assesses the cost-utility of home-based HPV self-sampling versus VIA for cervical cancer screening in India. A cross-sectional study was conducted in East district, Sikkim, India, comparing the costs and utility outcomes of population-based cervical cancer screening through VIA and primary HPV screening through self-sampling. Cost-related data were collected from April 2021 to March 2022 using the bottom-up micro-costing method, while utility measures were collected prospectively using the EuroQoL-5D-5L questionnaire. The utility values were converted into quality-adjusted life days (QALDs) for an 8-day period. The willingness to pay threshold (WTP) was based on per capita GDP for 2022. If the calculated Incremental Cost-Effectiveness Ratio (ICER) value is lower than the WTP threshold, it signifies that the intervention is cost-effective. The study included 95 women in each group of cervical cancer screening with VIA & HPV self-sampling. For eight days, the QALD was found to be 7.977 for the VIA group and 8.0 for the HPV group. The unit cost per woman screened by VIA and HPV self-testing was ₹1,597 (US$ 19.2) and ₹1,271(US$ 15.3), respectively. The ICER was ₹-14,459 (US$ -173.6), which was much below the WTP threshold for eight QALDs, i.e. ₹ 4,193 (US$ 50.4). The findings support HPV self-sampling as a cost-effective alternative to VIA. This informs policymakers and healthcare providers for better resource allocation in cervical cancer screening in Sikkim.

Exploring Oral Cancer Patterns: A 5-year Retrospective Analysis of Incidence, Clinical Features, Patient Behaviour and Treatment Outcomes at the Dental Unit of a Private Medical College and Hospital in Varanasi, Uttar Pradesh

Abstract Introduction: Oral cancer is a global health challenge. In India, there is a huge burden on the healthcare system. The prevalence of oral cancer globally and in India, coupled with the specific risk factors associated with the Indian population, necessitates targeted research to improve early detection and treatment outcomes. The present study analysed 93 patients with oral cancer over 5 years to determine the incidence corresponding to different stages of the disease. Materials and Methods: This retrospective cross-sectional study reviewed medical records from the hospital database. The epidemiological data included age, gender, tobacco habit, duration of tobacco use, site of the lesions, stages of cancer and the treatment provided. We analysed the relationship of epidemiological characteristics with age by the Chi-square test. The statistical test significance level was set at P < 0.05. Results: The incidences of oral cancer each year range from 8% to 12%. A male patient over 40 years of age was most affected by oral cancer 42 (45.16%). The most affected sites were buccal mucosa 36 (38.70%) and alveolus 33 (35.48%) amongst patients over 40 years of age. The predominant stage for the majority of cancer cases was Stage IV, accounting for 49 cases (52.68%). Additionally, the largest lesions, exceeding 4 cm in size, were observed in 64 cases (68.81%), and these instances were predominantly found in patients aged 40 years or older. Chewing tobacco emerged as a significant contributing factor to cancer, affecting 41 cases (42.08%), particularly among those with a habit duration exceeding 10 years, representing 48 cases (51.61%) in patients aged 40 years or older. Conclusion: There is an urgent need to spread awareness of oral cancer, followed by extensive screening in India. Tobacco in India is not only used widely but also associated with cultural relevance, and it is the need of the hour to implement the tobacco policy to reach out evenly to all communities.

Implementing a chest X-ray artificial intelligence tool to enhance tuberculosis screening in India: Lessons learned

Artificial Intelligence (AI) based chest X-ray (CXR) screening for tuberculosis (TB) is becoming increasingly popular. Still, deploying such AI tools can be challenging due to multiple real-life barriers like software installation, workflow integration, network connectivity constraints, limited human resources available to interpret findings, etc. To understand these challenges, PATH implemented a TB REACH active case-finding program in a resource-limited setting of Nagpur in India, where an AI software device (qXR) intended for TB screening using CXR images was used. Eight private CXR laboratories that fulfilled prerequisites for AI software installation were engaged for this program. Key lessons about operational feasibility and accessibility, along with the strategies adopted to overcome these challenges, were learned during this program. This program also helped to screen 10,481 presumptive TB individuals using informal providers based on clinical history. Among them, 2,303 individuals were flagged as presumptive for TB by a radiologist or by AI based on their CXR interpretation. Approximately 15.8% increase in overall TB yield could be attributed to the presence of AI alone because these additional cases were not deemed presumptive for TB by radiologists, but AI was able to identify them. Successful implementation of AI tools like qXR in resource-limited settings in India will require solving real-life implementation challenges for seamless deployment and workflow integration.

Newborn screening in India: A pressing priority

Newborn screening in India: A pressing priority

Awareness on human papilloma virus vaccine among medical students in rural area

Background: Cervical cancer, with an estimated 604,000 new cases and 342,000 deaths in 2020, is the fourth most common cancer among women globally. Low- and middle-income countries accounted for 90% of the new cases and deaths worldwide in 2020. Cervical cancer in females can be prevented to a great extent by vaccination. Implementation of the human papillomavirus (HPV) vaccine is still facing challenges, but it has the potential to address the challenges of cervical cancer screening in India. Implementation of HPV vaccination faces barriers of acceptance and lack of awareness, along with a high vaccine cost. Aims and Objectives: To assess the knowledge, attitude, and practise of the HPV vaccine among 1st and 2nd year medical students in a rural medical college. Materials and Methods: A descriptive cross-sectional study was conducted among 240 study subjects using a pre-tested, semi-structured questionnaire. The results were expressed in descriptive statistics like proportions and percentages. Results: 94% of the students were aware that cervical cancer is preventable, whereas 87% of them knew that cervical cancer can be prevented by a vaccine. 84% of the students had the knowledge that HPV vaccine is available in India. The maximum number of students were unvaccinated (92%), whereas 67% were ready to take the HPV vaccine in the future. Conclusion: Sensitization regarding the importance of the HPV vaccine to the general public can be achieved only when health care professionals are adequately aware of the safety and efficacy of the HPV vaccine. The first step in this direction is to educate the students who will form the backbone of our health care system in the future.

Research Gap in Health Literacy: Are We Overlooking a Possible Solution to Inadequate Cancer Screening in India?

India has one of the highest oral cancer burdens and accounts for one out of every five cervical cancer incidences worldwide. Majority of these preventable cancers are diagnosed in advanced stages with poor prognosis and survival. World Health Organization supports health literacy as a measure for accomplishing sustainable development goals. Community trials have reported that health literacy-focused interventions improve cancer screening participation and adherence. In India health literacy research is unutilized for cancer screening. Majority of the research utilized proxy information using disease-specific knowledge, attitude, and socio-demographic characteristics for screening participation. Through this correspondence, we discuss the poor cancer screening coverage in India and the research gap in health literacy in Indian context. Without an understanding of the distribution of the components of health literacy and the development of context-specific interventions for improvement, it will be difficult for any technology or innovation to penetrate the community and increase screening coverage.

Evolution of newborn screening in India and the way forward

Newborn screening (NBS) programs have gained recognition as successful initiatives in several developed countries. In India, the implementation of dried blood spot screening is slowly gaining traction, with both the private and public health-care sectors playing crucial roles. The objective of the study was to assess the evolution and current status of NBS programs in India and the contributions of the private and public sectors. The role of the private sector in NBS is explored, with private hospitals in urban areas offering screening options for parents willing to pay. The private facilities have better infrastructural facilities and technological capabilities as compared to government ones. We searched pubmed with the keywords NBS for metabolic disorders and inborn errors of metabolism, NBS in India and found out the relevant articles. Various public NBS programs in states such as Chandigarh, Goa, and Kerala are analyzed. The Chandigarh program, initiated in 2017, has emerged as a pioneering public NBS program in India, while Goa has implemented NBS programs in two phases, addressing shortcomings and focusing on follow-up and treatment resources. The Kerala program, initially a pilot, aims to screen every birth in government hospitals and expand to private hospitals. The Unique Methods of Management and Treatment of Inherited Disorders initiative by the Government of India and the Neonatal Early Evaluation Vision mission by the Delhi government are newer public sector initiatives targeting genetic disorders and metabolic error screening. The cost effectiveness of NBS program has been documented in low and middle income settings. With the major chunk of screening capabilities handled by private sector in Indian settings, it's imperative for funding and support for NBS in government settings. Achieving universal NBS in India may require time and concerted efforts; however, with improving health-care standards and financing mechanisms, there is optimism that NBS will find its routine and become a universally applied program.

Patterns in the prevalence and wealth-based inequality of cervical cancer screening in India

BackgroundCervical cancer is the second leading cause of deaths due to cancer among women in India. This study assesses the prevalence of cervical cancer screening among women in the 30 to 49 years age-group and its relation to demographic, social and economic factors. The equity in the prevalence of screening is studied with respect to the women’s household wealth.MethodsData from the fifth National Family Health Survey are analyzed. The adjusted odds ratio is used to assess the prevalence of screening. The Concentration Index (CIX) and the Slope Index of Inequality (SII) are analyzed to assess the inequality.ResultsThe average national prevalence of cervical cancer screening is found to be 1.97% (95% C.I, 1.8–2.1), ranging from 0.2% in West Bengal and Assam to 10.1% in Tamil Nadu. Screening is significantly more prevalent among the following demographics: educated, higher age group, Christian, scheduled caste, Government health insurance coverage, and high household wealth. Significantly lower prevalence is found among Muslim women, women from scheduled tribes, general category castes, non-Government health insurance coverage, high parity, and those who use oral contraceptive pills and tobacco. Marital status, place of residence, age at first sexual activity, and IUD usage are not significant influencers. At the national level, CIX (0.22 (95% C.I, 0.20–0.24)) and SII (0.018 (95% C.I, 0.015–0.020)) indicate significantly higher prevalence of screening among women from the wealthier quintiles. Significantly higher screening prevalence among wealthier quintiles in the North-East (0.1), West (0.21) and Southern (0.05) regions and among the poor quintiles in the Central (-0.05) region. Equiplot analysis shows a “top inequality pattern” in the North, North-East and Eastern regions, with overall low performance where the rich alone manage to avail screening. The Southern region exhibits an overall progress in screening prevalence with the exception of the poorest quintile, which is left behind. Pro-poor inequality exists in the Central region, with significantly higher prevalence of screening among poor.ConclusionThe prevalence of cervical cancer screening is very low (2%) in India. Cervical cancer screening is substantially higher among women with education and Government Health insurance coverage. Wealth-based inequality exists in the prevalence of cervical cancer screening and the prevalence is concentrated among the women from wealthier quintiles.

Abstract P5-04-03: Analyzing the performance of Thermalytix, an AI-based breast cancer screening solution, in a community setting

Abstract Background: Despite improvements in treatment strategies, breast cancer survival rates remain low in India due to a lack of awareness and late stage of presentation. If diagnosed and treated early, breast cancer survival rates improve. Screening mammography, the gold standard in cancer diagnosis, is not feasible in a resource-constrained setting. Niramai’s novel breast cancer screening technology, Thermalytix™, applies Artificial Intelligence (AI) over thermography, to give an automated interpretation of the breast thermal images. The portable Thermalytix test has been so far used to screen 60000 women in community settings across India and Kenya. This study is a recent evaluation of the test in rural setting. Methods: Women who provided written consent and who underwent Thermalytix tests in community-based screening camps at primary health centers (PHCs) in Afzalpur Taluk of Gulbarga District, Karnataka, India between 01 August 2021 to 15 June 2022 were included in this study. Five thermal images in multiple views were analyzed using Niramai’s patented algorithm. Automated analysis of the thermal images produced a screening report and triaged the participants for follow-up. In case of abnormal thermal activity, Thermalytix triaged women as ‘red’ and were referred to the district hospital for follow-up with breast ultrasound and/or other investigations and and were recorded into the following three categories: Normal (BI-RADS 1), Abnormal - benign (BI-RADS 2/3) and Abnormal - malignant (BI-RADS 4/5). If no abnormal thermal patterns were detected by Thermalytix, women would be recommended routine screening. Findings: The analysis included 3531 women were included in the analysis and the median age in the cohort was 42 years. Of them, 97 (2.74%) women were triaged ‘red’ by Thermalytix indicating a suspicion of breast abnormality. As on 15 June 2022, 29 (30%) out of 97 women underwent standard follow-up investigations of which two cases of carcinoma breast, one case of phyllodes, one case of tuberculosis mastitis and seven other benign cases were identified, indicating that Thermalytix has a positive predictive value of 35.71% (11/29) in detecting benign and malignant breast lesions. Furthermore, a Patient experience questionnaire was used to asses their experience. 98.71% women were being screened for breast cancer for the first time in their lives. 93.9% women said they were very satisfied with Thermalytix screening experience and remaining 6.1% said they were satisfied, thus aiding in strong acceptability and adoption of the test. Interpretation: In resource-constrained settings such as India, where less than 2% of the women in the country have ever got screening for breast cancer, the portable, no-radiation Thermalytix test is an accessible breast cancer screening solution. Thermalytix’s patient-friendly features - privacy-aware, painless, comfortable, and radiation-free make it favorable for population screening in India, and thus, can increase the uptake of breast cancer screening. With the device’s capacity to fit into a backpack, it can make breast cancer screening accessible to even remote areas with limited resources. However, following up on women who were found to be Thermalytix positive still remains a challenge. Future studies will emsure that follow-up after abnormal breast screening is part of the approved clinical protocol. Results of the screening program 3 malignancies and 8 benign lesions found in 29 Thermalytix RED patients Citation Format: Geetha Manjunath, Lakshmi Krishnan, Gargi Deshpande, Purnima Madhivanan, Karl Francis Krupp. Analyzing the performance of Thermalytix, an AI-based breast cancer screening solution, in a community setting [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-04-03.

Geographic Variation and Factors Associated with Breast Cancer Screening in India Using a Spatial Durbin Approach

Geographic Variation and Factors Associated with Breast Cancer Screening in India Using a Spatial Durbin Approach

The compelling necessity for improvement in cancer screening in India in this decade

In 2020, cancers of the breast, lip and oral cavity and cervix were the three most common cancers in India.(1) The national programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) recommends a population-based screening for identifying pre-cancerous lesions and early detection of these three cancers by front line health workers.(2) Data about cancer screening has been included in the latest National Family Health Survey (NFHS-5).(3) We have tried to understand the current status of cervical, breast and oral cancer screening in India.

Expanding the horizon for breast cancer screening in India through artificial intelligent technologies-A mini-review.

Breast cancer is one of the most common cancer among Indian women, with an incidence of 25.8 per 100,000 women according to the Ministry of Health and Family Welfare. Late detection is responsible for poor quality of life (QOL), and it is the leading cause of death. In metropolitan regions, one in every 22 women will have breast cancer over their lifetime; but in rural areas, one in every 60 women will develop breast cancer as per estimates. This paper aims to describe the various AI based breast screening technologies which are used in breast cancer screening in India. The literature search was done using "Pub Med," "Google scholar," and "Scopus" databases for the key terms "technology," "cancer research," "artificial intelligence," "mammography", "breast cancer," "cancer," and/or "neoplasia in breast." All the relevant articles were included to support this mini review. We found that emerging artificial intelligent technologies namely "Niramai", "iBreastExam," "MammoAssist" are emerging as an hope for early detection by screening in resource poor settings, in turn, which can improve the QOL among breast cancer patients.

Resistance Evaluation for Native Potato Accessions against Late Blight Disease and Potato Cyst Nematodes by Molecular Markers and Phenotypic Screening in India.

The potato originated in southern Peru and north-western Bolivia (South America). However, native accessions have also been cultivated in India for many years. Late blight, caused by the fungus Phytophthora infestans, is the most devastating potato disease, while potato cyst nematode (Globodera spp.) (PCN) is another economically significant quarantine-requiring pest in India. In this study, we have generated a new Indian native collection of 94 potato accessions collected from different parts India. These accessions were screened against late blight and potato cyst nematode resistance by using gene-based molecular markers and phenotypic screening methods. Marker assisted selection using R1 gene-specific marker CosA210 revealed a late blight resistance gene in 11 accessions. PCN resistance bands were found in 3 accessions with marker TG689141, 5 accessions with marker 57R452, and 1 accession having Gro1-4-1602 marker for G. rostochiensis (Ro1,4), while 64 accessions amplified marker HC276 indicating G. pallida (Pa2,3) resistance gene (GpaVvrn QTL). On the other hand, phenotypic screening against late blight resistance under natural epiphytic conditions (hot-spot) revealed three accessions with high resistance, while others were resistant (1 accession), moderately resistant (5 accessions), susceptible (29 accessions), and highly susceptible (56 accessions). For G. rostochiensis (golden cyst nematode) and G. pallida (white cyst nematode) resistance, accessions were grouped into highly resistant (3, 3), resistant (0, 2), moderately resistant (6, 29), susceptible (32, 30), and highly susceptible (53, 30), respectively, for the two PCN species. Collectively, we identified promising accessions with high resistance to late blight (JG-1, Kanpuria Safed, and Rangpuria), and also highly resistant to both Globodera species (Garlentic, Jeevan Jyoti, and JG-1). Our findings suggested that these accessions would be useful for late blight and PCN resistance breeding, as well as future molecular studies in potatoes.

Improving Dementia Screening in India with Telemedicine and Artificial Intelligence: A Scalable Solution to Address Clinical Gaps in Care

AbstractBackgroundOver 4.4 million people live with Alzheimer’s and related dementia (ADRD) in India. There is significant clinical service gap of 90% and only 1 in 10 patients affected with ADRD in India receives screening, diagnosis, treatment, and care. Combining telemedicine with an “Expert system,” can help evaluate, screen, and triage patients with ADRD and reduce the time to diagnosis. We demonstrate early results from a feasibility study that uses state‐of‐the‐art Artificial Intelligence (AI), data analytics, and a HIPAA‐compliant Telehealth platform to screen patients over 65 years in India for ADRD.MethodWe integrated AI‐based platform and a standardized cognitive test into the telemedicine‐based primary‐care workflow. A primary care provider (PCP) screened every consenting patient aged 65 years and older on a telemedicine platform in India. The screening used an algorithm‐based intake tool, baseline Mini‐Mental Status Exam (MMSE), and clinical judgment of the PCP. We compared the final screening assessment generated by AI with the MMSE evaluation and clinical judgment of PCP for nine patients.ResultsNine patients (4 females, 5 males) in age group of 65‐90 years consented and enrolled in this initial study. Using the intake data as inputs, the AI model predicted MCI in 5 out of 9 patients (55%) and mild ADRD in 4 out of 9 patients (44%). The clinical severity from the tele‐encounter was rated as mild ADRD in 3 out of 9 patients (33%) and no ADRD/Mild Cognitive Impairment in 6 out of 9 patients (66%). Neuropsychological testing with the MMSE demonstrated scores from 24‐30 in 7 out of 9 patients (77%) and <24 in 2 out of 9 patients (22%). The AI model accurately predicted the severity in 6 out of 9 patients (66.6%) of cases.ConclusionIt is feasible to combine AI and telemedicine to improve ADRD screening and clinical service gaps for healthcare delivery in India. AI severity models also demonstrated adequate predictability to triage patients who have cognitive impairment using digital intake data. The accuracy of the AI prediction models may be further improved with supplemental electronic medical data and translating the intake to a local language.

Blood Donation Screening of Transfusion-Transmissible Viral Infection Using Two Different Nucleic Acid Testing (NAT) Platforms: A Single Tertiary Care Oncology Centre Experience.

Nucleic acid testing (NAT) is used to screen transfusiontransmittable infections (TTIs) in donated blood samples and provide an additional layer of blood safety. In this study, we describe our experience in screening viral TTIs using two formats of NAT: cobas® MPX2 polymerase chain reaction- based minipool NAT (PCR MP-NAT) and Procleix Utrio Plus transcription-mediated amplificationbased individual donor-NAT (TMA ID-NAT). Data routinely collected as a part of blood bank operations were retrospectively analysed over a period of 70months for TTIs. Blood samples were initially screened for HIV, HBV, HCV, syphillis by chemiluminescence and malaria by Rapid card test. In addition to serological testing, all samples were further screened by TMA-based ID-NAT (ProcleixUltrio Plus Assay) during Jan 2015-Dec 2016, and by PCR-based MP-NAT (Cobas® TaqScreen MPX2) during Jan 2017-Oct 2020. RESULTS: A total of 48,151 donations were processed over 70months, of which 16,212 donations were screened by ProcleixUtrio Plus TMA ID-NAT and 31,939 donations by cobas® MPX2 PCR MP-NAT. Replacement donors and male donors outnumbered voluntary donors and female donors respectively. The overall NAT yield rate of MP-NAT was 1:2281 compared to 1:3242 with ID-NAT, during the respective time period. ID-NAT detected 5 HBV infections missed by serology, whereas MP-NAT detected 13 HBV infections and 1 HCV infection missed by serology. The proportion of donations that were both seroreactive and NAT reactive was higher with MP-NAT (59.8%) compared to ID-NAT (34.6%). Cobas® MPX2MP-NAT had higher overall NAT yield rate compared to ProcleixUtrio Plus ID-NAT and confirmed a higher proportion of seroreactive donations. Due to the ease of operation, simple algorithm, cobas® MPX2 PCR based MP-NAT can be an effective solution for blood screening in India.