title: Tuberculosis management practices by private practitioners in Andhra Pradesh, India.
abstract: METHODS
  Private medical practitioners in Visakhapatnam district, Andhra Pradesh, India.
  
  
  OBJECTIVE
  To evaluate self-reported TB diagnostic and treatment practices amongst private medical practitioners against benchmark practices articulated in the International Standards of Tuberculosis Care (ISTC), and factors associated with compliance with ISTC.
  
  
  METHODS
  Cross- sectional survey using semi-structured interviews.
  
  
  RESULTS
  Of 296 randomly selected private practitioners, 201 (68%) were assessed for compliance to ISTC diagnostic and treatment standards in TB management. Only 11 (6%) followed a combination of 6 diagnostic standards together and only 1 followed a combination of all seven treatment standards together. There were 28 (14%) private practitioners who complied with a combination of three core ISTC (cough for tuberculosis suspects, sputum smear examination and use of standardized treatment). Higher ISTC compliance was associated with caring for more than 20 TB patients annually, prior sensitization to TB control guidelines, and practice of alternate systems of medicine.
  
  
  CONCLUSIONS
  Few private practitioners in Visakhapatnam, India reported TB diagnostic and treatment practices that met ISTC. Better engagement of the private sector is urgently required to improve TB management practices and to prevent diagnostic delay and drug resistance.
authors: World Health Organization (WHO) Country Office in India, New Delhi, India. AchantaS@rntcp.org
authors: Shanta
authors: S
authors: Achanta
authors: Jyoti
authors: J
authors: Jaju
authors: Ajay M V
authors: AM
authors: Kumar
authors: Sharath Burugina
authors: SB
authors: Nagaraja
authors: Srinivas Rao Motta
authors: SR
authors: Shamrao
authors: Sasidhar Kumar
authors: SK
authors: Bandi
authors: Ashok
authors: A
authors: Kumar
authors: Srinath
authors: S
authors: Satyanarayana
authors: Anthony David
authors: AD
authors: Harries
authors: Sreenivas Achutan
authors: SA
authors: Nair
authors: Puneet K
authors: PK
authors: Dewan
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011331:Private Practice; D014376:Tuberculosis / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult
references: Health Policy. 2005 Apr;72(1):93-104
references: 15760702
references: Int J Epidemiol. 2002 Oct;31(5):894-9
references: 12435756
references: PLoS Med. 2007 Jul 24;4(7):e238
references: 17676945
references: Int J Tuberc Lung Dis. 2004 Oct;8(10):1255-9
references: 15527159
references: Int J Tuberc Lung Dis. 2003 Jan;7(1):52-7
references: 12701835
references: PLoS Med. 2011 Aug;8(8):e1001062
references: 21857806
references: Health Aff (Millwood). 2007 May-Jun;26(3):w380-92
references: 17389635
references: J Infect Dis. 2001 Aug 15;184(4):473-8
references: 11471105
references: Health Policy Plan. 1995 Dec;10(4):333-49
references: 10154358
references: J Glob Infect Dis. 2011 Jan;3(1):19-24
references: 21572604
references: Int J Tuberc Lung Dis. 1998 Dec;2(12):1005-10
references: 9869117
references: Tubercle. 1991 Dec;72(4):284-90
references: 1811360
references: JAMA. 1998 Mar 25;279(12):943-8
references: 9544769
references: BMC Public Health. 2008 Jan 14;8:15
references: 18194573
references: PLoS Med. 2008 Jul 22;5(7):e156
references: 18651788
references: Int J Tuberc Lung Dis. 2005 Jan;9(1):61-8
references: 15675552
references: Indian J Tuberc. 2010 Oct;57(4):199-206
references: 21141338
references: Health Aff (Millwood). 2012 Dec;31(12):2774-84
references: 23213162
references: Int J Tuberc Lung Dis. 1998 Apr;2(4):324-9
references: 9559404
references: PLoS One. 2011;6(9):e24160
references: 21912669
references: Int J Tuberc Lung Dis. 2003 Jul;7(7):611-5
references: 12870680
references: PLoS One. 2010 Aug 09;5(8):e12023
references: 20711502
references: PLoS One. 2011 May 04;6(5):e18964
references: 21573227
references: Am J Respir Crit Care Med. 2003 Feb 15;167(4):603-62
references: 12588714