EFFECT OF PROVIDING FREE SPUTUM MICROSCOPY SERVICE TO PRIVATE PRACTITIONERS ON CASE NOTIFICATION TO NATIONAL TUBERCULOSIS CONTROL PROGRAM
AbstractBackground: This study was undertaken to see whether providing free sputum microscopyservices to private practitioners helps in case notification to the national tuberculosis controlprogram. The knowledge, attitudes and practices of these practitioners regarding tuberculosis werealso evaluated. Methods: A questionnaire was administered to all the private practitionerspracticing in a densely populated area of Karachi. They were asked to fill tuberculosis notificationcards for the first three months and then for another three months when an incentive in the form offree sputum microscopy was provided to the practitioners. Results: Although the majority of thepractitioners knew that cough, fever and weight loss are the main symptoms of tuberculosis, lessthan half knew that blood in sputum, poor appetite and chest pain could also be associated withtuberculosis. Only 66% of the practitioners indicated sputum microscopy as the preferreddiagnostic method for tuberculosis. Only 50% of the practitioners self treated the patients, whilethe remaining half referred their patients to specialists. Around 80% of the practitioners wereaware of the four first-line anti-tuberculosis drugs. Less than half of the practitioners consideredsputum microscopy as the most useful follow-up investigation in a patient with pulmonarytuberculosis. Generally, there was a poor response in case notification by private practitioners onprovision of free sputum microscopy. Conclusion: An overwhelming majority of the practitionershad poor knowledge concerning the correct treatment practices in Tuberculosis. Providing sputumfree microscopy does not significantly help in improving tuberculosis case notification. Strategiesfor public-private collaboration in tuberculosis control are needed.Keywords: tuberculosis, private practice, sputum, microscopy, knowledge, attitude, behaviour,Pakistan.
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