KNOWLEDGE, ATTITUDE AND PRACTICE OF PRIVATE PRACTITIONERS REGARDING TB-DOTS IN A RURAL DISTRICT OF SINDH, PAKISTAN

Authors

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

Abstract

Background: Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge,
attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have
been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural
area of Sindh, Pakistan. Methods: This survey was conducted in January 2007 at Thatta, a rural
district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of
district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS
training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and
management 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 advised
sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different
combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over
40% 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 clinical
improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance
to the TB treatment and none of PPs were following the retrieval of default cases. Conclusions: A
gross lack of PPs knowledge and right practice regarding TB diagnosis and management through
DOTS was identified and needed to be addressed through providing DOTS training.
Keywords: Tuberculosis, DOTS, private practitioners, knowledge, practice

References

National TB Control Program Pakistan/About NTP. [On

line]. 2006 [cited 2007 March 24]. Available from:

http://www.ntp.gov.pk/about.htm

WHO Report 2007/Global Tuberculosis Control/Key

Findings. [On line]. 2007 [cited 2007 March 24]. Available

from: http://www.who.int/tb/publications/global_report/2007/

pdf/keyfindings.pdf

WHO Report 2007/Country Profile/Pakistan. [On line]. 2007

[cited 2007 March 24]. Available from: http://www.who.int/

tb/publications/global_report/2007/pdf/pak.pdf

Marsh D, Hashim R, Hassany F, Hussain N, Iqbal Z,

Irfanullah A, et al. Front-line management of pulmonary

tuberculosis: an analysis of tuberculosis and treatment

practices in urban Sindh, Pakistan. Int J Tuberc Lung Dis

;77:86-92.

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.

Raman AV, Chadha VK, Shashidhara AN, Jaigopal MV,

Selvam. A study of knowledge, attitude and practices of

medical practitioners regarding tuberculosis and its control in a

backward area of South India. NTI Bulletin 2000;36(1-2):3-7.

Uplekar MW, Rangan S. Private doctors and tuberculosis

control in India. Tubercle Lung Dis 1993;74:332-7.

Uplekar MW, Juvekar SK, Parande SD, Dalal DB,

Khanvilkar SS, Vadair AS, et al. Tuberculosis management

in private practice and its implications. Indian J Tuberc

;43:19-22.

Singla N, Sharma PP, Singla R, Jain RC. Survey of

knowledge, attitude and practices for tuberculosis among

general practitioners in Delhi, India. Int J Tuberc Lung Dis

;2:384-9.

Khan JA, Akbani F, Malik A, Kazi GN, Aslam F, Hussain

SF. Effect of providing free sputum microscopy service to

private practitioners on case notification to national

tuberculosis control program. J Ayub Med Coll Abbottabad

;17(14):31-5.

Shah SK, Sadiq H, Khalil, Noor A, Rasheed G, Shah SM, et

al. Do private doctors follow national guidelines for

managing pulmonary tuberculosis in Pakistan? East Mediterr

Health J 2003;9(4):776-88.

Population Census, Sindh results. Bureau of statistics,

Planning and Development Department, Government of

Sindh, Kehkashan, Karachi-6. 1998.

Murty KJ, Frieden TR, Yazdani A, Hreshikesh P. Publicprivate partnership in tuberculosis: experience in Hyderabad,

India. Int J Tuberc Lung Dis 2001;5(4):354-9.

Published

2009-03-01

How to Cite

Ahmed, M., Fatmi, Z., Ali, S., Ahmed, J., & Ara, N. (2009). KNOWLEDGE, ATTITUDE AND PRACTICE OF PRIVATE PRACTITIONERS REGARDING TB-DOTS IN A RURAL DISTRICT OF SINDH, PAKISTAN. Journal of Ayub Medical College Abbottabad, 21(1), 28–31. Retrieved from https://www.jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3772

Most read articles by the same author(s)