Roles of NRLs

• National Reference Laboratories (NRLs) conducts annual on-site evaluation/supervisory visits to laboratories for assessing the quality of microscopy, culture and drug susceptibility test (C&DST), and for improvement of the overall laboratory quality. 
• NRLs also assist Central TB Division (CTD), in developing laboratory guidelines, standard operating procedures (SOPs), and conduct training to state-level Intermediate reference laboratories (IRLs) and other technical issues.
• NRLs conduct C&DST training to the IRLs, and develop SOPs for the technical procedures, equipment maintenance, infection control and recording and reporting. 
• NRLs are also responsible for offering second-line drug susceptibility tests (DST) for multi-drug resistant TB (MDR-TB) treatment failures. 
• NRLs are responsible for the accreditation of the mycobacteriology laboratory for culture and drug sensitivity testing under the National Tuberculosis Elimination Program (NTEP).
• In addition, NRLs are also responsible for the conduct of research for the programme and evaluation of newer tools for the diagnosis of TB.
• The National Institute for Research in Tuberculosis (NIRT) Chennai, the Supranational Reference Laboratory (SRL) of the region is responsible for the external quality assurance of the other 5 NRLs. NIRT is in turn quality-assured through the SRL coordinating laboratory at Antwerp, Belgium. 

Assessment Questions