Do doctors in north-western Somalia follow the national guidelines for tuberculosis management?

ABSTRACT

A cross-sectional study assessed the knowledge and practices of registered practitioners in management of tuberculosis [TB] in north-western Somalia. Of 100 registered doctors, 53 were interviewed. Of these, 32 [64%] had treated TB patients during the previous year, but only 1 had notified the authorities, 33 [66%] knew the most important symptoms and 32 [64%] identified sputum smear microscopy as the most important diagnostic test. Only 4 doctors prescribed the correct regimen and only 7 advocated direct observation. Suboptimal knowledge was more common among doctors working in private practice [relative risk 2.1; 95% CI 1.1-4.3]. Patients are being treated in the private sector, but few doctors follow national treatment guidelines. Training in diagnosis and case management is needed to improve TB control in Somalia