A cross sectional study to assess the diagnostic and management practices of general practitioners regarding tuberculosis in an urban slum of Mumbai, Maharashtra

Authors

  • G. B. Sawase Department of Community Medicine, Government Medical College, Aurangabad, Mumbai, Maharashtra, India
  • S. M. Achrya Department of Community Medicine, Government Medical College, Aurangabad, Mumbai, Maharashtra, India
  • R. R. Shinde Department of Community Medicine, Government Medical College, Aurangabad, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20172857

Keywords:

TB, RNTCP, DOTS, Private practitioners

Abstract

Background: India has large and growing private medical sector and it is observed that Private Practitioners are generally the first point of contact for significant proportion of patients with tuberculosis. Hence the present study was carried out to assess the diagnostic and management practices for tuberculosis among the private practitioners in an urban slum area.

Methods: A cross sectional study was conducted in the field practice area of Urban Health Centre attached to the teaching hospital and medical college. A total of 76 Private Practitioners practising in the field practice area were contacted, explained the purpose and benefits of the study, 67 private practitioners gave consent for involvement in the study. A semi structured and pretested questionnaire was used to interview the private practitioners. Data was analyzed by using SPSS software version 17.0.

Results: Among 67 Private Practitioners in the area only 19 (28.4%) doctors mentioned that they diagnose TB patients in their clinic and start the diagnosed TB patients on treatment. Persistent cough (97%), fever (86.5%), weight loss (58.2%) were the most common symptoms of TB identified by these doctors. The mean duration for suspecting TB mentioned was 3.79 weeks. Chest x-ray was the most common (85.1%) investigation advised. HRZE was the drug regimen of choice whereas few doctors gave various anti-TB drugs including 2nd line drugs like kanamycin, PAS, cycloserine to their patients.

Conclusions: In present study showed majority of the private practitioners are neither updated nor very particular about the diagnosis and correct regimen of anti TB therapy. A few doctors also used 2nd line anti-TB drugs drugs like kanamycin, PAS, cycloserine to their patients which shows the likely irrational use of the few available anti-tuberculosis drugs, which may favour the emergence and spread of drug resistance. 

 

References

Central TB Division, Indian Medical Association and WHO-India. Training module for medical practitioners. New Delhi: Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India; 2010: 4.

Hopewell PC, Pai M, Maher D, Uplekar M, Raviglione MC. International standards for tuberculosis care. Lancet Infect Dis. 2006;6(11):710-25.

Srivastava DK, Mishra A, Mishra S, Gour N, Bansal M, Mishra S, et al. An Assessment of Knowledge and Practices Regarding Tuberculosis in the Context of RNTCP Among Non-Allopathic Practitioners in Gwalior District. Online J Health Allied Scs. 2011;10(2):5.

Shimeles E, Aseffa A, Yamuah L, Tilahun H, Engers H. Knowledge and practice of private practitioners in TB control in Addis Ababa. Int J Tuberc Lung Dis. 2006;10(10):1172-7.

Khan J, Malik A, Hussain H, Ali NK, Akbani F, Hussain SJ, et al. Tuberculosis diagnosis and treatment practices of private physicians in Karachi, Pakistan. East Mediterr Health J. 2003;9(4):769-75.

Yimer SA, Holm-Hansen C, Bjune G. Assessment of knowledge and practice of private practitioners regarding tuberculosis control in Ethiopia. J Infect Dev Ctries. 2012;6(1):13-9.

Portero JL, Rubio M. Private practitioners and tuberculosis control in the Philippines: strangers when they meet? Trop Med Int Health. 2003;8(4):329-35.

Prasad R, Nautiyal RG, Mukherji PK, Jain A, Singh K, Ahuja RC. Diagnostic evaluation of pulmonary tuberculosis: what do doctors of modern medicine do in India? Int J Tuberc Lung Dis. 200;7(1):52-7.

Singla N, Sharma PP, Singla R, Jain RC. Survey of knowledge, attitudes and practices for tuberculosis among general practitioners in Delhi, India. Int J Tuberc Lung Dis. 1998;2(5):384-9.

Udwadia ZF, Pinto LM, Uplekar MW. Tuberculosis management by private practitioners in Mumbai, India: has anything changed in two decades? PLoS One. 2010;5(8):e12023.

Uplekar MW, Shepard DS. Treatment of tuberculosis by private general practitioners in India. Tubercle. 1991;72(4):284-90.

Uplekar M, Juvekar S, Morankar S, Rangan S, Nunn P. Tuberculosis patients and practitioners in private clinics in India. Int J Tuberc Lung Dis. 1998;2(4):324-9.

Downloads

Published

2017-06-23

How to Cite

Sawase, G. B., Achrya, S. M., & Shinde, R. R. (2017). A cross sectional study to assess the diagnostic and management practices of general practitioners regarding tuberculosis in an urban slum of Mumbai, Maharashtra. International Journal Of Community Medicine And Public Health, 4(7), 2548–2554. https://doi.org/10.18203/2394-6040.ijcmph20172857

Issue

Section

Original Research Articles