Diagnostic and Treatment Protocol Adopted by Private Practitioners of Surat City for Drug Resistant Tuberculosis Patients
Author:Prakash B Patel, Jayesh J Rana, R K Bansal
Keywords:Private Practitioners, Drug resistant TB, Diagnostic and treatment protocols
Abstract:"Introduction: In recent years, the emergence of Multi Drug Resistant (MDR) TB has become a significant public health problem. In India, 50–80% of TB patients still pursue care at private sectors. It is crucial that private providers follow RNTCP guidelines for treatment of TB and MDR TB. This study explores the practices adopted by Private Practitioners for diagnosis and management of Drug Resistant Tuberculosis patients in Surat city of Western India. Methodology: In this descriptive cross sectional study of Private Physicians of Surat city were selected randomly from IMA Surat member list. A pre-test questionnaire including Profile of the doctor, Profile of patients suspected for MDR TB, Diagnostic & Treatment practices and Follow up issues was used to collect data. Data Analysis was done using Epi-info software calculating descriptive statistics. Results: Most common investigative methods used by private physicians to diagnose MDR TB were sputum microscopy, x-ray chest and sputum culture. Commonly used second line drugs for MDR TB patients were Fluoroquinolones, Aminoglycosides and Ethionamide. Nearly three forth physicians preferred 4 or more drug combination for MDR TB treatment. Most of them preferred 2 or 3 second line drugs in their prescriptions. Common investigations preffered by them during follow up were Sputum AFB, Culture and Chest X-Ray. Conclusion: Compliance to recommended standards of MDR TB management was common among the private physicians but quite a few were unacceptable in context of WHO recommendations. There is need to streamline these protocols according to the general guideline for MDR TB management."