Difficult-to-Treat TB Clinic [DT3C]

The Difficult-to-treat TB clinic (DT3C) is an initiative to support Drug-resistant TB Centres (DR-TBCs) for better patient management. 

The DT3C structure is intended to handhold and mentor District DR-TB centres (DDR-TBCs) for the effective management of Drug-resistant TB (DR-TB) cases.

Figure: Difficult-to-treat TB Clinic: Three-tier Structure

The DT3C operates via a three-tier structure which is intended to improve the quality of DR-TB care:

1. The DT3C is functional at the national level through the collaboration of the National Institute for Tuberculosis and Respiratory Diseases (NITRD), Central TB Division (CTD) and the National Task Force (NTF).
2. Experts involving various specialties are included in the team as mentors at state-level D3TC.
3. Information/ queries regarding the patient are shared in a standardized format by the DDR-TBC beforehand to facilitate discussions through the state nodal officer. 
    

All states should have at least one (more than one in larger states) DT3C established.

Resources

• Guidelines for Programmatic Management of Drug-resistant TB in India, 2021: Guidance on Establishment of State Level difficult-to-treat TB clinic (S-DT3C), p212-215.