ABSTRACT
BACKGROUND: Globally, tuberculosis (TB) remains a significant cause of morbidity and mortality having caused 1.6 million deaths in 2021. Uganda is a high TB burden country with a large private sector that serves close to 60% of the urban population. However, private for-profit health facilities' involvement with the National TB and Leprosy Program (NTLP) activities remains poor. This study evaluated the practices of diagnosis and treatment of pulmonary tuberculosis (PTB) and associated factors among practitioners in private for-profit (PFP) healthcare facilities in Kampala, Uganda. METHODS: We conducted a cross-sectional study among randomly selected private practitioners in Uganda's largest city, Kampala. A structured questionnaire was used for data collection. Descriptive statistics and generalized linear models with log Poisson link were used to analyze data. Practices were graded as standard or substandard. RESULTS: Of the 630 private practitioners studied, 46.2% (95% confidence interval (CI): 26.6 to 67.1) had overall standard practices. Being a laboratory technician (prevalence ratio (PR) = 2.7, p< 0.001) or doctor (PR = 1.2, p< 0.001), a bachelor's degree level of qualification (PR = 1.1, p = 0.021), quarterly supervision by the national TB program (PR = 1.3, p = 0.023), and acceptable knowledge of the practitioner about TB (PR = 1.8, p<0.001) were significantly associated with standard practices. CONCLUSIONS: The practices of TB management for practitioners from the PFP facilities in Kampala are suboptimal and this poses a challenge for the fight against TB given that these practitioners are a major source of primary health care in the city.
Subject(s)
Private Sector , Tuberculosis , Humans , Uganda , Cross-Sectional Studies , Private PracticeABSTRACT
INTRODUCTION: Ethiopia has a growing private health sector. In recent years, the directly observed treatment short course (DOTS) strategy was initiated in selected private health facilities in the country. The objective of the present study was to assess knowledge and practice of private practitioners in tuberculosis (TB) control in Amhara Region, Ethiopia. METHODOLOGY: An institution-based cross-sectional study was conducted among 112 private practitioners selected from all private health facilities in the region. The study was conducted between May and August 2008 and data was collected using a semi-structured questionnaire. Group differences were analyzed using the chi-square test. RESULTS: Fifty-nine (52.7%) of the private practitioners suspected TB in patients with three weeks' duration of cough. Only 37 (33.0%) of the private practitioners were able to precisely list the correct treatment regimens for all categories as recommended in the National Tuberculosis and Leprosy Control Program guidelines. The correct frequency of TB treatment monitoring was provided by 44 (50%) of the respondents. Overall 44 (39.3%) of the private practitioners did not have satisfactory knowledge about the directly observed treatment short course (DOTS) strategy. Those who attended DOTS training during the two years prior to the survey were more likely to have satisfactory knowledge compared to those who did not receive training (OR 4.45, 95% CI: 1.33, 14.87, p < 0.02). CONCLUSION: A significant proportion of private practitioners did not have satisfactory knowledge and practice about DOTS. The provision of regular DOTS refresher courses improves TB management for patients in the region.
Subject(s)
Clinical Competence , Health Knowledge, Attitudes, Practice , Private Practice , Tuberculosis/prevention & control , Adult , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Cross-Sectional Studies , Directly Observed Therapy , Drug Therapy, Combination , Ethiopia , Female , Humans , Male , Middle Aged , Private Practice/statistics & numerical data , Surveys and Questionnaires , Tuberculosis/diagnosis , Tuberculosis/drug therapy , Tuberculosis/epidemiologyABSTRACT
The private providers especially private practitioners are the first contact points for any types of ailments both in the urban and rural situations. From 2001 onwards, the services for National Leprosy Eradication changed to integrated system involving general healthcare system. Special emphasis is laid on correct diagnosis of leprosy cases before declaring and putting them under multidrug therapy. The government doctors were provided repeated training for this capacity building to diagnose and manage all diagnosed cases. Government of India also arranged practice of giving orientation programme to the private practitioners through IMA in the year 2004-05. The private practitioners can support the programme through case diagnosis, continuation of treatment and spreading awareness.
Subject(s)
Delivery of Health Care, Integrated , Family Practice/organization & administration , Health Planning , Leprosy/prevention & control , National Health Programs/organization & administration , Private Practice , Program Development , Public Health/education , Awareness , Communicable Disease Control , Humans , India/epidemiology , Leprosy/diagnosis , Leprosy/epidemiologyABSTRACT
Leprosy can affect all age groups. In 1991 the World Health Assembly took major initiative towards global elimination of the disease. It was possible to achieve 90% reduction in leprosy cases all over the world. India is not lagging behind to eliminate leprosy as Government of India, various NGOs and IMA have joined hands to fight the menace aggressively. During the year 2004-05 the IMA organised training workshops on leprosy for private practitioners, who are mostly members of IMA. After the completion of workshops a wrap-up workshop was organised in each state. It was a treat opportunity for the IMA to mobilise its resources to contribute to the national cause.
Subject(s)
Education, Medical, Continuing , Family Practice/education , Leprostatic Agents/therapeutic use , Leprosy/prevention & control , Public Health/education , Societies, Medical/organization & administration , Awareness , Communicable Disease Control/organization & administration , Education , Family Practice/organization & administration , Health Planning , Humans , India , Leprosy/diagnosis , Leprosy/drug therapy , Private Practice , Program DevelopmentABSTRACT
SETTING: Urban municipality of 150000 citizens in Kathmandu Valley, Nepal. OBJECTIVE: To determine 1) the perceptions among private pharmacists of characteristics of tuberculosis (TB) patients visiting private pharmacies in the area, 2) the sales of different anti-tuberculosis drugs, and 3) the interaction between private health providers and pharmacists. DESIGN: Between January and April 1998, semi-structured interviews were conducted with 98% (49/50) of the private drug-retailers in the area. RESULTS: Thirty-two (65%) pharmacies had sold anti-TB drugs during the last month. Forty-three (88%) said that most TB patients were of low socio-economic status and rarely bought drugs for more than a week at a time. Only eight (16%) reported that TB patients usually returned to buy the full course of drugs. Seventy-two per cent of total spending on anti-tuberculosis drugs was for different kinds of combinations of drugs. Nine per cent was spent on plain rifampicin, believed to be sold only to tuberculosis/leprosy patients. During the previous month, 5/13 (38%) of pharmacies with no doctors attached had sold anti-tuberculosis drugs compared with 27/38 (71%) of pharmacies with doctors attached to them (P < 0.05). CONCLUSION: The private sector offers an available and acceptable but non-affordable service for many TB patients. A substantial amount of anti-TB drugs are being sold in the private pharmacies. There is therefore a potential role for pharmacists to play in collaborative efforts between the private and public sector in TB control activities.