Management of TB in the private sector in Khartoum, Sudan: quality and impact on TB control

Sudan has a large and growing private health sector. No survey was done in Sudan to show the extent of the use of private health care services by the population. Also precise data on tuberculosis [TB] diagnosis and treatment in the private sector are not available. A facility-based cross-sectional survey was carried out during February 2007 - June 2007 in Khartoum state, whereby consented private physicians working in the all private clinics [n=110] were interviewed. This study showed that a large private sector exist in the country and deliver care to TB patients and reported the non-adherence of this sector to National Tuberculosis Program [NTP] guidelines. 59.1% of the interviewed physicians correctly mentioned the TB treatment regimens, only 8 [12.3%] physicians that reported management of TB patients actually prescribed these regimens to their patients. Similarly, only 10 [15.4%] physicians required sputum smear examination for TB diagnosis. A considerable proportion of cases is inadequately managed by the private sector and is not notified to NTP. The information delivered by this study can be used to develop a workable Public-private mix [PPM] model with the private sector

Risk of Mycobacterium tuberculosis infection in Somalia: national tuberculin survey 2006

To estimate the annual risk of tuberculosis [TB] infection [ARTI] in Somalia a tuberculin survey was conducted in February/March 2006. Stratified cluster sampling was carried out within the 18 regions and 101 randomly selected primary schools. Tuberculin testing was done in 10 680 grade 1 schoolchildren. Transverse tuberculin reaction size was measured 72 hours later. The number of children with a satisfactory test read was 10 364. The overall BCG coverage was 54%. Based on frequency distribution of tuberculin reaction sizes, the ARTI in Somalia was estimated at 2.2% [confidence interval: 1.5%-3.2%]. There was an annual decline of 2.6% comparing with a previous study in 1956

Simultaneous bilateral percutaneous nephrolithotomy in Pakistan

Twenty three simultaneous bilateral nephrolithotomy cases performed in a remote area of the country are presented. The method was applied to the properly selected patients, considering the size, shape and position of the bilateral kidney stones. Minimum age of the patient was 4 years and maximum 70 years. In our opinion simultaneous bilateral percutaneous nephrolithotomy [SBPN] is the treatment of choice in properly selected cases with bilateral renal stones. It is even beneficial in cases who have dense and staghorn stones where Extracorporeal Shockwave Lithotripsy [ESWL] does not work. It is advantageous for the patient to be operated upon through SBPN as compared to consecutive percutaneous operations or open nephrolithotomy. This procedure is less time consuming for the urologist. Risk of operative and postoperative complications is negligible and hospital stay is short. The patient can resume his daily routine life at the earliest and it is cost effective procedure for him