c) Involvement of Private Practitioners
AU : Uplekar MW, Juvekar SK & Shepard DS
TI : Treatment of tuberculosis by private general practitioners in India
SO : TUBERCLE 1991, 72, 284-290
DT : Per
AB :

Early detection and optimal treatment constitute the most important measures in the control of TB. A study of doctors practicing in a large low income settlement of Bombay was carried out to find out the prescribing pattern for treatment of TB. The doctors selected by simple random were a mixture of those qualified in western medicine (allopaths) and those qualified in indigenous systems such as Ayurveda, Homeopathy and Unani (non-allopaths). From the list of total 287 doctors, 143 were selected. The sample included 79 allopaths and 64 non-allopaths.

All the doctors were requested to write a prescription for a previously untreated adult case of sputum positive pulmonary TB indicating drug used, dosages and duration. The slips were collected by the Investigator on the spot and later analysed by EPI-INFO software. Of the 143 doctors, 31 (22%) refused participation in the study. The final analysis included 102 doctors (48 allopaths and 54 non-allopaths). Hundred doctors using two or more of the five anti-TB drugs (S, H, R, Z & E) prescribed 80 different regimens non-confirmed with standard recommended regimen except for two doctors who wrote indigenous drugs. None of them employed thioacetazone as the anti-TB drug or recommended intermittent regimen.

This study highlights that irrespective of their background and training, most of the doctors use modern chemotherapeutic agents in the treatment of TB. Most of the regimens were inappropriate, expensive and of long duration of 12-24 months.

This inefficient use of scarce resources may be avoided through Continuing Medical Education of private doctors by experts. Effective media and other possible modes of communication could be used to educate lay people about the disease, the importance of regularity of treatment. Ways need to be considered to make private doctors participate in effective implementation of programme, for which their curative functions could contribute significantly to control the disease.