The Laboratory Services Division under the National AIDS Control Programme (NACP) in Mizoram ensures that HIV and STI testing adhere to the highest standards of quality, accuracy, and reliability.

The NACP laboratories located at the Department of Microbiology, Zoram Medical College & Hospital—including the State Reference Laboratory (SRL), State Reference Centre (SRC), and Viral Load Testing Laboratory—operates within a robust quality assurance framework.

1. State Reference Laboratory (SRL) for HIV Testing:

Hierarchy of oversight:

Apex Laboratory: NITVAR, Pune

↓

 National Reference Laboratory (NRL): NIRBI, Kolkatta

↓

     State Reference Laboratory (SRL): Department of Microbiology, ZMC&H

↓

         Integrated Counselling and Testing Centers (ICTC): 39 ICTC across the state

External Quality Assessment (EQA):

• Rechecking/Retesting (Quarterly: Jan, Apr, Jul, Oct):

  • ICTCs submit 20% of positive and 5% of negative samples from the first week of each quarter.

  • The SRL revalidates them, and concordance is consistently 100%.

• Proficiency Testing (Biannually: May, Oct):

  • NRL sends blinded serum panels to SRL, which again distributes them to ICTCs.

  • Both SRL and ICTCs report results, with 100% concordance—allowing early detection of any kit or procedural errors.

• On-Site Evaluation:

  • Technical officers from Mizoram SACS routinely audit and mentor all 39 ICTCs, review records, and identify training needs.

2. State Reference Centre (SRC) – STI Diagnosis:

State Reference Centres is designated STI laboratories at the state level. The centre is equipped and staffed to provide technical support, training, quality assurance, and diagnostics for STI/RTI management across the state.

A. Confirmatory and Etiologic Testing:

Identification of causative organisms for various STI/RTI syndromes.

B. Antibiotic Susceptibility Testing (AST):

Especially crucial for monitoring Neisseria gonorrhoea resistance patterns.

C. Participation in External Quality Assessment (EQA):

Ensuring quality and reliability in syphilis testing and other diagnostics.

D. Training and Capacity Building:

Mentoring Designated STI/RTI Clinics (DSRCs) and district laboratories on testing protocols, quality assurance, and infection control.

E. External Quality Assurance (EQA) for Syphilis Testing:

NACO’s STI/RTI control programme includes a structured External Quality Assurance (EQA) framework, overseen by Regional STI Training, Research and Reference Laboratories (RSTRRLs located at Guwahati Medical College, Assam)

3. Viral Load Testing Laboratory:

Mizoram SACS, guided by NACO’s “Treat All” policy, offers routine, free viral load (VL) testing to people living with HIV (PLHIV) registered at 14 ART Centres across the state:

Testing Protocol

• First VL at 6 months after ART initiation.

• Thereafter, every 12 months on first-line ART; every 6 months on second/third-line ART

If VL > 1000 copies/mL:

• Enhanced adherence counselling (EAC)

• Repeat VL after 3 months

Quality assurance:

• Participation in proficiency testing programs

• Rigorous QC across public and private labs

4. Additional Quality Measures undertaken:

• CD4 EQA (May & October):

  • Coded CD4 samples from NARI, Pune, distributed to 8 ART centres (Aizawl, Lunglei, Champhai, Kolasib, Kulikawn, Mamit, Serchhip, Siaha).

  • Data ensures machine and personnel reliability.

• NACP Lab Accreditation & Standards:

  • All NACP labs must comply with NABL ISO 15189:2022 Accreditation

  • Quality Management System (QMS) per ISO 9000:2007, covering all testing phases; 29 ICTCs hold Certificates of Excellence

• NABL MELT Certification for SA-ICTC:

  • Top-performing ICTCs awarded a 5-star NACO Coe could apply for NABL MELT certification.

  • 26 of 29 outstanding ICTCs received certification

Summary

Mizoram’s NACP Laboratory Services Division upholds the integrity of HIV and STI diagnostics through:

• A multi-tiered reference laboratory structure

• Regular EQA cycles and on-site monitoring

• Accreditation to ISO standards

• Quality management systems

• Ongoing capacity building for all testing sites

These efforts collectively secure consistent, accurate, and high-quality testing services across the state.