‘We are not aware of notification of tuberculosis’: A mixed‐methods study among private practitioners from western India

Abstract

Background Implementing the Standards for tuberculosis care in India (STCI) guidelines in the private sector is vital. This study attempted to estimate the knowledge and practices regarding STCI guidelines among private practitioners and to explore the reasons and solutions for low tuberculosis (TB) notification rates. Methods We conducted a cross‐sectional study for assessing the knowledge and practices of the STCI guidelines among 100 full‐time allopathic private practitioners in Bhavnagar (in western part of India) from September 2018 to January 2019. Knowledge and practice were categorised as good or poor by assigning scores to the responses to a questionnaire based on the STCI guidelines. It was followed by two focus group discussions to explore the reasons and solutions for low notification rates of TB as perceived by private practitioners. Results Among the 100 private practitioners, 55% had good knowledge, and 41% had good practice regarding the STCI guidelines; 69% knew about the gazette notification of mandatory notification of TB, and 58% were notifying TB cases to the government. Lack of awareness about the process as well as incentives for notification, time constraints and infrequent visits by health workers were the main reasons perceived by private practitioners for not notifying TB cases to the government. The critical solutions suggested by them were creating awareness regarding the notification process as well as incentives, increasing health worker visits and use of social media for notification. Conclusion Only about half of private practitioners follow the STCI guidelines for TB care, and the notification rates are low in our setting. Regular sensitisation programs need to be arranged for private practitioners to create awareness on TB notification.

Mirage de tuberculose in the 21st century

“…Most of our participants preferred messaging applications such as SMS and WhatsApp group chat as a way to report TB cases; this is in line with findings from other studies. 18 , 25 Additionally, around half of our participants also mentioned that in the last 6 months, they were not visited by CHCs officers for TB case reporting.…”

“…Furthermore, CHCs officers should monitor TB case recording and reporting from private providers regularly. 25 , 29 …”

Practice regarding tuberculosis care among physicians at private facilities: A cross-sectional study from Vietnam

“…According to the International Standards for Tuberculosis Care (ISTC) and the Vietnam Ministry of Health’s guidelines for TB diagnosis and treatment, CXR findings alone are unreliable for diagnosing TB, and sputum examination must be performed when CXR findings are suggestive [ 15 , 17 ]. In other studies, CXR alone was the preferred investigations for the diagnosis of TB in 45,4%–68% of the participants [ 18 – 21 ]. This tendency could either be due to the lack of knowledge among private practitioners regarding the availability/reliability of sputum smear in TB diagnosis, or to the fact that the CXR/CT scan is faster and more convenient, making it more suitable for the practice in private sector, where private providers are frequently under pressure to provide immediate results to their clients.…”

Development and Validation of the Knowledge, Attitude, and Practice Questionnaire for Community Pharmacy Personnel in Tuberculosis Case Detection, Drug Monitoring, and Education: A Study from Indonesia

“…1 A study conducted in western India indicated that private practitioners are still slow in raising TB notifications. 54 Collaboration within private practitioners and community pharmacy is expected to raise TB case notification. Community pharmacy personnel can screen pharmacy visitors for TB signs and symptoms and refer presumptive TB patients to healthcare facilities or community healthcare centers for further examination as has been done in India and Pakistan 13 , 15 to enhance the notification of TB cases.…”