Setting: Directly Observed Treatment Short-course is a key pillar of the global strategy to end tuberculosis. Objective: The effectiveness of community-based compared to facility-based DOTS on tuberculosis treatment success rates in Namibia was assessed. Methods: Annual tuberculosis treatment success, cure, completion and case notification rates were compared between 1996 and 2015 by interrupted time series analysis. The intervention was the upgrading by the Namibian government of the tuberculosis treatment strategy from facility-based to community-based DOTS in 2005.Results: The mean annual treatment success rate during the pre-intervention period was 58.9% (range: 46-66%) and significantly increased to 81.3% (range: 69-87%) during the post-intervention period. Before the intervention there was a non-significant increase (0.3%/year) in the annual treatment success rate. After the intervention, the annual treatment success rate increased abruptly by 12.9% (p <0.001) and continued to increase by 1.1%/year thereafter. The treatment success rate seemed to have stagnated at approximately 85% at the end of the observation period.
Conclusion:Expanding facility-based DOTS to community-based DOTS significantly increased the annual treatment success rates. However, the treatment success rate at the end of the observation period had stagnated below the targeted 95% success rate.
Background: Optimal collaboration between pharmacists and other healthcare professionals such as physicians is integral in implementing pharmaceutical care. However, there are concerns regarding the role of pharmacists, especially among low- and middle-income countries. This study explored the perceptions, expectations, and experience of physicians working in various hospital settings of Punjab, Pakistan, about pharmacists and their roles.Methods: A self-administered questionnaire consisting of four sections was administered from October to December 2020. Descriptive and inferential statistics such as Kruskal-Wallis and Mann-Whitney tests were used for data analysis using SPSS.Results: Six hundred and seventy-eight physicians participated in this study with a response rate of 77.9%. Most of the physicians reported minimal to no interaction with pharmacists (n = 521, 76.8%). However, more than three-quarters of physicians (n = 660, 97.3%) accepted pharmacists as evidence-based sources of drug information. In addition, many physicians (n = 574, 84.7%) strongly agreed that pharmacists should attend patient care rounds to respond promptly to questions related to patient medication. A limited number of physicians (n = 124, 18.3%) assumed that pharmacists were advising their patients regarding the judicial use of their drugs. Median expectation and experience score had a significant association with age, experience, and education of physicians (P < 0.05).Conclusions: The perception of physicians was positive toward certain roles of pharmacists, coupled with high expectations. However, their experience was low, with most of the activities of pharmacists due to inadequate interprofessional coordination.
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