||Uplekar MW, Juvekar SK & Shepard DS
||Treatment of tuberculosis by private general practitioners
|| TUBERCLE 1991, 72, 284-290
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.
|KEY WORDS: PRIVATE DOCTORS; GENERAL PRACTITIONER; DOCTORS