National Tuberculosis Center

Laboratory Networks

NTP LABORATORY NETWORKS

NATIONAL TB CONTROL PROGRAMME LABORATORY NETWORK

1. Sputum smear microscopy remains the key tool for diagnosis of infectious tuberculosis. National Tuberculosis Control Programme operates through a network of laboratories with permanent Quality Control System. Central Laboratory at National Tuberculosis Centre is responsible for planning, training, monitoring, supervision, and evaluation of the laboratory network in the country. Central Laboratory also provides quality control services for the Central Region.   

NTP LABORATORY NETWORK COVERAGE

Currently there are 427 microscopy centres offering smear microscopy services, among these 354 operates within Government Health System, 49 through partner NGOs and 24 in Private Sector. Culture and DST facilities are available from NTC and GENETUP laboratories at the central level.

QUALITY ASSURANCE

NTP laboratory network is working under a quality assurance system in order to maintain and improves standards. Every four month all-positive and 10 percent of the negative slides are cross checked by Regional Quality Control Centres. Regular feedback is provided to all the laboratories and NTC. Continuous improvement in agreement of slides reading has been noticed (false positive and false negative slides) over the past several years. Training and supervision supplements regular quality assurance programme. During year 2064/2065 all districts participated in the Quality Control programme. Overall agreement rate of cross checked slides during 2006/07 was 90%. Initially five Regional Quality Control Centres were established with help of partners namely; Britain Nepal Medical Trust (BNMT), National Anti Tuberculosis Association (NATA), International Nepal Fellowship (INF) and the Netherlands Leprosy Relief NLR). However, more regional quality control centres are now operating independently under the NTC and Regional Health Directorates these includes Quality Control (QC) Laboratory in the Western and Mid Western Regions. Currently, BNMT and NATA are supporting the QC Lab in the Eastern Region while NLR supports in the Far Western Region.

During the reporting year 2007/08, NTP started piloting and field testing of Standard Operating Procedures for smear microscopy as part of WHO global initiative. Currently this initiative is ongoing in three districts which will be expanded to rest of country. NTP also introduced Lot Quality Assurance System (LQAS) system to improve Quality Control System. Training on LQAS system was held for all regions, Patan and Hospital. Piloting LQAS system piloting started in the following sites:

• Eastern Region: Mornag district (12 microscopic centres)
• Central Region: Patan, Bhaktapur and Korean Hospitals
• Western Region: Kaski Districts (5 microscopic centres)
• Mid Western Region: Sukhet DHO, Regional Hospital, Mehalkuna PHC, NMC Neplagunj, NMC Kohalpur, Bankutara PHC and INF Nepalgunj
• Far Western Region: Kailali DHO, Tikapur Hospital, Dodhara HP.

 

---