Nodal DR-TB Centre

Nodal Drug-resistant Tuberculosis Centres (NDR-TBCs) are established to manage all forms of DR-TB, including complicated cases. ​Therefore, the centre should have:

• Advanced general laboratory
• Allied investigation facilities for Pre-treatment Evaluation (PTE)
• Intensive Care Unit (ICU)
• Ventilator backup
• In-house lab/ linkages for PTE laboratory tests

The NDR-TBC is established as per the need and is generally in a tertiary care setting where expertise and facilities for the management of DR-TB are available. ​

The figure below shows an overview of services offered at the NDR-TBC.

Figure: Range of Services Available at NDR-TBCs

District DR-TB Centres (DDR-TBCs) are linked with the NDR-TBC for the referral and management of complicated DR-TB patients like those who have:​

• Additional resistance to second-line drugs, drug intolerance, serious adverse drug reactions, and contraindications ​
• Failing regimen, or patients returning after treatment interruption of more than 1 month​
• The emergence of any exclusion criteria for a standard regimen for rifampicin-resistant TB or H mono/ poly DR-TB regimen​
• Non-TB mycobacterial infections
• Need for palliative care or surgical interventions

Resources

• Guidelines for Programmatic Management of Drug-resistant TB in India, 2021.

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