TB laboratory network

A strong TB laboratory network is essential to ensure timely and universal access to quality-assured diagnostics. Trained human resources, adequate infrastructure, equipment, a quality assurance system, a sample transportation network, a supply of commodities, and a monitoring system are key components of such a laboratory network.

NTRL is an apex laboratory in TB laboratory network which works along with the PPHL and Provincial TB Laboratory present in each province to provide quality assured TB laboratory diagnosis service to the patients. There are 133GeneXpert machines in 117GeneXpert centers in 68 districts to provide TB diagnosis and rapid DST to patients. There are currently 785TB designated microscopy centers (DMC) across the country. Sample collection centers further under DMC or mWRD centers with a robust sample transportation system are planned to increase accessibility to TB lab services.

National Tuberculosis Reference Laboratory (NTRL)

National Tuberculosis Control Center Laboratory is a public health laboratory that has been rendering TB laboratory services across the country. The Laboratory was established in 1989 as a central-level TB laboratory and it was upgraded to a National Tuberculosis Reference Laboratory (NTRL) in 2013. It is the highest authority of TB diagnostic network. It provides TB diagnostic services, monitors the progress of TB treatment, and assists in the management of TB patients.

The NTRL provides TB diagnostic services as:

• Microscopy (Fluorescent Microscopy)
• TB diagnosis and rapidDrug Susceptibility Testing (DST) by mWRD (Xpert MTB/RIF Ultra and Xpert XDR)
• Mycobacterial Culture services: solid culture (LJ media) and liquid culture (MGIT)
• PhenotypicDST using MGIT for the first and second-line TB drugs
• Genotypic DST by Line Probe Assay (LPA) method for the first and second-line TB drugs

It receives referral samples from drug resistance (DR) treatment centers from 5 provinces: Province 1, Madhesh Province, Bagmati Province, Gandaki Province, and Lumbini Province to monitor the prognosis of the DR-TB patients. The referral samples from Karnali Province and Sudurpaschim Province are processed in NATA/GENETUP laboratory.

The responsibilities of the NTCC, NTRL include

• To coordinate at the national level for policies and activities related to TB laboratory services
• To provide technical inputs to NTP on various issues concerning TB laboratory network and services.
• To provide technical support to the PPHL, and TTC for planning and training in TB diagnostic services in the province
• Planning and training to the provincial TB culture lab and mWRD centers,
• Supervision and on-site coaching to provincial TB culture lab, mWRD centers, and designated microscopy center
• Preparation of GeneXpert external quality control panels for MTB,
• Logistic supplies such as GeneXpert cartridges, GeneXpert machines, sputum containers, and other commodities.

Laboratory Contact Details:

NTCC Laboratory, Thimi, Bhaktapur

+977-01-6630706 / +977-01-6630832

Email: ntrl.ntcc@gmail.com