title: Do private doctors follow national guidelines for managing pulmonary tuberculosis in Pakistan?
abstract: As private medical practitioners play a major role of in providing care to pulmonary tuberculosis (TB) patients, a survey was made of knowledge and practice in 2 cities in Pakistan. Only 1 of the 245 physicians was aware that cough > 3 weeks alone is the main symptom suggesting pulmonary TB. The majority diagnosed (80%) and treated (83%) cases themselves without referral. Less than 1% relied on sputum microscopy alone for diagnosis. None of the practitioners were following National TB Control guidelines for prescribing drugs and none ensured compliance with anti-TB treatment under supervision of a doctor/health worker. Only 3% kept records of pulmonary TB patients. None of the physicians assessed the effectiveness of treatment with sputum microscopy alone; the majority (76%) used only clinical assessment.
authors.affiliation: National Tuberculosis Control Programme, Rawalpindi, Pakistan.
authors.forename: S K
authors.initials: SK
authors.lastname: Shah
authors.forename: H
authors.initials: H
authors.lastname: Sadiq
authors.forename: M
authors.initials: M
authors.lastname: Khalil
authors.forename: A
authors.initials: A
authors.lastname: Noor
authors.forename: G
authors.initials: G
authors.lastname: Rasheed
authors.forename: S M
authors.initials: SM
authors.lastname: Shah
authors.forename: N
authors.initials: N
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000359:Aftercare / Q000592:standards; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003371:Cough / Q000382:microbiology; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education / Q000523:psychology / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011331:Private Practice / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards; D013183:Sputum / Q000382:microbiology; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019037:Urban Health Services / Q000592:standards
chemical_list: D000995:Antitubercular Agents