Difficult to Treat TB Clinic D3T

 PMDT Guidelines 2021 recommends all states to start Difficult to Treat TB Clinic (SD3T).  All District TB Officers, Medical Officers and Private Practitioners in the state can send their difficult to manage drug resistance cases for discussion in the SD3T Clinic.  Faculty from state academic institutes and leading private practitioners are chosen experts for the session.  The cases are referred to this clinic in the PPT form in a standard pre-designed format.  This is assigned to one of the experts for their opinion.  During the session, the referring doctor presents the details of case history including medical and treatment history with all the investigations and follow up details, and then presents the issues encountered in managing the particular case.  All the participants (DTOs, MOs and Supervisors) of the state attending the session also give their opinion and share their experience in managing such cases.  After this, experts give their suggestions in managing the case.  At the end session coordinator prepares recommendations for the case management which is sent to the doctor who presented the case.


In Delhi state, this SD3T is being conducted on Delhi state STDC ECHO Hub and managed by the faculty of New Delhi TB Centre since August, 2011. 


Actually from the start of STDC ECHO Hub in 2017, a case-based clinical discussion for paramedical staff was being conducted every first Wednesday of month.  As per PMDT 2021 guidelines, now this has been renamed as SD3T clinic and now participants include DTOs, MOs and private practitioners.  Second part of SD3T is didactics, usually related to the case presented or any about latest aspect of TB management to be delivered by faculty of NDTB Centre, medical colleges and other academic institutes of Delhi state.