ABSTRACT
A significantly strengthened Revised National Tuberculosis Control Programme (RNTCP) is currently operational in India. In this case-based commentary, we describe the plight of a patient who developed extensive drug-resistant tuberculosis (XDR-TB) despite having received treatment under the RNTCP for a long period. Our aim is to analyse the programmatic management of tuberculosis in India by highlighting and discussing various issues related to the treatment received by the patient. Further, the article explores whether there is a need to incorporate an ethical element into the RNTCP as it stands today.
Subject(s)
Adult , Antitubercular Agents/therapeutic use , Delayed Diagnosis/adverse effects , Delivery of Health Care/standards , Disease Management , Drug Resistance , Extensively Drug-Resistant Tuberculosis/diagnosis , Extensively Drug-Resistant Tuberculosis/drug therapy , Extensively Drug-Resistant Tuberculosis/etiology , Female , Health Services Needs and Demand , Humans , India , Medical Errors , Public Health Practice/standards , Treatment Outcome , Tuberculosis/drug therapy , Young AdultABSTRACT
Introduction: India has the highest burden of tuberculosis in world, accounting for 20% of global incidence of TB (Tuberculosis). TB treatment is available both in private and public sector in India. Aim & objectives: The current study was carried out to study and compare the prescribing practices of anti-tuberculosis medications by private practitioners and healthcare providers in public sector (under RNTCP-Revised National Tuberculosis Control Programme). Material and Methods: 105 anti TB prescriptions of private practitioners and 105 RNTCP (Revised National Tuberculosis Programme) treatment cards were analysed. Results: 9.52% prescriptions by private practitioners and 4.76 % RNTCP prescriptions were correct. Factors for drug resistance were present in 67.62 % of prescriptions by private practitioners and 28.57 % of RNTCP prescriptions whereas overdosing was present in 53.33 % of prescriptions by private practitioners and 68.57 % of RNTCP prescriptions. Conclusion: The anti TB treatment offered in private and public sector in India is not satisfactory at present and needs to be improved.
ABSTRACT
The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations was recently amended regarding the relationship between doctors and professional associations of doctors and the pharmaceutical and allied health sector industry. Many of these amendments are not practical. For example, how many readers of this journal have not accepted a single gift from pharmaceutical companies? All of us accept at least a ball point pen. Likewise, very few of us have attended conferences and continuing medical education programmes spending money from our own pockets. Pharmaceutical companies will continue the same practices but unofficially. And many senior physicians will continue to accept sponsored holidays.