title: Engaging general practitioners in public-private mix tuberculosis DOTS program in an urban area in Pakistan: need for context-specific approach.
abstract: A public-private mix tuberculosis (TB) DOTS project was implemented to enhance coverage and collaboration between the public and private sectors, with an objective to increase case detection and to improve TB case management in a large urban area. General practitioners (GPs) were trained to provide DOTS services. Patients were diagnosed and treated as per national guidelines and outcomes were reported to national TB control program. Treatment and sputum microscopy were provided free of cost. A total of 94 GPs were trained. In all, 57.4% of trained GPs remained actively involved in the project. Overall treatment success rate of the patients enrolled with the project was 86.3% with 8.7% default patients. Experience suggests that a more stringent selection criteria need to be followed for inclusion of GPs in the program to improve the success of the program. A multifaceted context specific approach is needed while working with private health care providers.
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Amin
authors.initials: A
authors.lastname: Pethani
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Mubashir
authors.initials: M
authors.lastname: Zafar
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Adeel Ahmed
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Unaib
authors.initials: U
authors.lastname: Rabbani
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Sana
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Aga Khan University, Karachi, Pakistan zafar.fatmi@aku.edu.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003299:Cooperative Behavior; D023801:Directly Observed Therapy / Q000379:methods*; D019468:Disease Management; D058005:General Practitioners / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training; D007373:Interinstitutional Relations; D010154:Pakistan; D017149:Private Sector / Q000458:organization & administration*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy*; D014505:Urban Population
chemical_list: D000995:Antitubercular Agents
keywords: DOTS; National Tuberculosis Programme; Pakistan; public–private mix; tuberculosis