title: 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 improveTB control in Somalia.
authors.affiliation: World Health Organization, Hargeisa, Somalia.
authors.forename: B A
authors.initials: BA
authors.lastname: Suleiman
authors.forename: A I
authors.initials: AI
authors.lastname: Houssein
authors.forename: F
authors.initials: F
authors.lastname: Mehta
authors.forename: S G
authors.initials: SG
authors.lastname: Hinderaker
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D019090:Case Management / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D003430:Cross-Sectional Studies; D023801:Directly Observed Therapy / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010820:Physicians / Q000458:organization & administration / Q000523:psychology; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D017149:Private Sector; D017150:Public Sector; D012998:Somalia; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents