ABSTRACT
As private medical practitioners play a major role of in providing care to pulmonary tuberculosis [TB] patients, a survey was made of knowledge and practice in 2 cities in Pakistan. Only 1 of the 245 physicians was aware that cough > 3 weeks alone is the main symptom suggesting pulmonary TB. The majority diagnosed [80%] and treated [83%] cases themselves without referral. Less than 1% relied on sputum microscopy alone for diagnosis. None of the practitioners were following National TB Control guidelines for prescribing drugs and none ensured compliance with anti-TB treatment under supervision of a doctor/health worker. Only 3% kept records of pulmonary TB patients. None of the physicians assessed the effectiveness of treatment with sputum microscopy alone; the majority [76%] used only clinical assessment
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aftercare/standards , Antitubercular Agents , Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Practice Patterns, Physicians'/standards , Physicians, Family/standards , Private Practice/standards , Referral and Consultation/standards , Sputum/microbiologyABSTRACT
OBJECTIVE: To determine the health care seeking behavior of TB patients in seeking care and health care providers for delivering care. DESIGN: Cross sectional descriptive survey. The interviewers administered a standardized open-ended questionnaire after training and pre-testing. SETTING: Federal Government TB Center, Rawalpindi. [specialized TB clinic]. SUBJECT: One hundred and sixty newly registered TB patients at TB Center, Rawalpindi between 20 November to 21 December 1998. Prior to their consulting TB Center, 96% patients had already reported to a health care provider, i.e., to first, second or third health care providers. OF 154 patients, 48 were diagnosed as TB and only 29 [19%] of them received antituberculosis treatment. Most of the patients 118 [77%] consulted the health care provider within three weeks time. Delay is more on part of health care providers than on patients. Proper implementation of guidelines of TB program with public-private sector collaboration and continuing education of health care providers is necessary