title: TB management by private practitioners - Is it bad everywhere?
abstract: BACKGROUND
  Poor prescribing practice is alleged to be one of the major factors fuelling the drug-resistant tuberculosis (DR TB) emergence. A study in Mumbai revealed the extent of inappropriate tuberculosis (TB) management practices of private practitioners and discussed that with the context of high DR TB. Kerala is rated among the well performing States in India as far as TB control is concerned with evidences for a lower level of TB transmission and DR TB. The current study was done in Kerala State to assess the prescribing practices of private sector doctors in the treatment of TB.
  
  
  METHODS
  Survey questionnaire to write a standard prescription for treating TB was administered to private practitioners dealing with TB, who attended continuing medical education programme on TB at two major cities in Kerala.
  
  
  RESULTS
  Responses from a total of 124 questionnaires were studied. None of them prescribed anti-TB regimen for less than 6 months. Only 7 (5.6%) prescribed a regimen without complete four drugs (H, R, Z, E) in the intensive phase. Out of the 81 doctors who prescribed private anti-TB regimen, 67 (82.7%) had of the opinion that not less than 80% of their patients complete the treatment for the prescribed duration.
  
  
  CONCLUSIONS
  The current study reports a reasonable TB management practice among the private sector doctors from a State with a low prevalence of DR TB and compliments the argument that effective treatment of TB following the principles of standards for TB care can prevent the emergence of DR TB.
authors.affiliation: Amrita Institute of Medical Sciences and Research Center, Amrita Viswavidhyapeetham, Kerala, India. Electronic address: rakeshrenjini@gmail.com.
authors.forename: P S
authors.initials: PS
authors.lastname: Rakesh
authors.affiliation: WHO RNTCP Technical Assistance Project, WHO Country Office, India.
authors.forename: Shibu
authors.initials: S
authors.lastname: Balakrishnan
authors.affiliation: Project Director, Kerala State AIDS Control Society, India.
authors.forename: S
authors.initials: S
authors.lastname: Jayasankar
authors.affiliation: Dean Hospital, Punalur, Kerala, India.
authors.forename: R V
authors.initials: RV
authors.lastname: Asokan
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007194:India; D010818:Practice Patterns, Physicians'; D011331:Private Practice; D017149:Private Sector; D014376:Tuberculosis; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents
keywords: Drug prescriptions; Public private partnership; Standards of TB Care in India; Tuberculosis