title: Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.
abstract: BACKGROUND
  The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners.
  
  
  METHODS
  We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time.
  
  
  RESULTS
  The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0).
  
  
  CONCLUSIONS
  Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.
authors.affiliation: School of Public Health, Faculty of Medicine, Udayana University, Bali, Indonesia. gedeartawan@gmail.com.
authors.forename: I Wayan Gede
authors.initials: IW
authors.lastname: Artawan Eka Putra
authors.forename: Ni Wayan Arya
authors.initials: NW
authors.lastname: Utami
authors.forename: I Ketut
authors.initials: IK
authors.lastname: Suarjana
authors.forename: I Made Kerta
authors.initials: IM
authors.lastname: Duana
authors.forename: Cok Istri Darma
authors.initials: CI
authors.lastname: Astiti
authors.forename: I W
authors.initials: IW
authors.lastname: Putra
authors.forename: Ari
authors.initials: A
authors.lastname: Probandari
authors.forename: Edine W
authors.initials: EW
authors.lastname: Tiemersma
authors.forename: Chatarina Umbul
authors.initials: CU
authors.lastname: Wahyuni
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003151:Community Health Centers / Q000706:statistics & numerical data*; D023801:Directly Observed Therapy; D005260:Female; D006291:Health Policy; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011331:Private Practice / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents