• Mubashir Ahmed
  • Zafar Fatmi
  • Sajid Ali
  • Jamil Ahmed
  • Naseem Ara


Background: Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge,attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management havebeen reported only in urban areas of Pakistan. This survey was conducted for the first time in a ruralarea of Sindh, Pakistan. Methods: This survey was conducted in January 2007 at Thatta, a ruraldistrict of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors ofdistrict Thatta, who were practicing in private setups for at least last one year. Before TB-DOTStraining PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis andmanagement through DOTS. Survey data was analysed through SPSS version 11.05 software.Results: On average, five TB suspects per month were seen by each PP. Only 14% of PPs advisedsputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used differentcombination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs(85%) did not follow the treatment through sputum microscopy and instead relied on clinicalimprovement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show complianceto the TB treatment and none of PPs were following the retrieval of default cases. Conclusions: Agross lack of PPs knowledge and right practice regarding TB diagnosis and management throughDOTS was identified and needed to be addressed through providing DOTS training.Keywords: Tuberculosis, DOTS, private practitioners, knowledge, practice


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