title: Private practitioners and tuberculosis case detection in Jogjakarta, Indonesia: actual role and potential.
abstract: BACKGROUND
  Indonesia has a high tuberculosis (TB) prevalence and a large private health sector.
  
  
  OBJECTIVE
  To explore the potential of private practitioners (PP) in TB control in Jogjakarta by assessing their load of TB suspects and case-management practices.
  
  
  METHODS
  We conducted a cross-sectional telephone survey of a random sample of 164 PP, weighted to the local proportions of specialists, general practitioners (GP), nurses and midwives. We investigated their knowledge of directly observed treatment, short-course (DOTS), whether they see TB suspects, whether they refer such patients and how they possibly diagnose and treat TB.
  
  
  RESULTS
  We sampled 174 PP, of which 164 (94.3%) completed the interview. Most PP (63.4%) reported to have seen TB suspects in their private practice, and 62.8% were also employed in a DOTS facility. Specialists saw on average 18 suspects, GP 11 suspects, and nurses-midwives three suspects in a year. Many PP (45.2%) always relied on National Tuberculosis Control Programme (NTP) services for diagnosis. Fewer PP (41.5%) used, by themselves, diagnostic procedures complying with the NTP guidelines. The majority (63.6%) always referred confirmed cases for treatment, mainly (71.4%) to NTP services. Most PP (72.7%) who treated TB patients themselves did not prescribe the NTP standard regimen.
  
  
  CONCLUSIONS
  The study shows that the TB case load per PP is low in Jogjakarta, where the NTP already involves public and private hospitals besides public health centres. Initiatives to engage all PP might only marginally contribute in increasing the TB case detection.
authors.affiliation: Epidemiology and Disease Control Unit, Public Health Department, Institute of Tropical Medicine, Antwerp, Belgium. yodi_mahendradhata@yahoo.co.uk
authors.forename: Yodi
authors.initials: Y
authors.lastname: Mahendradhata
authors.forename: Adi
authors.initials: A
authors.lastname: Utarini
authors.forename: Upiek
authors.initials: U
authors.lastname: Lazuardi
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.forename: Patrick Van der
authors.initials: PV
authors.lastname: Stuyft
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007214:Indonesia; D008297:Male; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011331:Private Practice; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*