Adherence of the private sector to national tuberculosis guidelines in the Islamic Republic of Iran, 2001-02

Shirzadi, Mohammad Reza; Majdzadeh, Reza; Pourmalek, Farshad; Naraghi, Kamran

doi:10.26719/2003.9.4.796

Cited by 8 publications

(2 citation statements)

References 8 publications

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“…A study conducted in Iran found 50% of clinicians have knowledge of and adhere to correct treatment guidelines [ 11 ]. The results of this study indicate a lack of knowledge, which poses a threat to TB control in the country and can be the reason for emerging as well as spreading drug resistance.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, Attitude, and Practices Among Healthcare Practitioners in the Context of Multidrug Resistance Tuberculosis: An Appraisal to Disease Elimination

Jain¹,

Rath²,

Mohanty³

et al. 2023

Cureus

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Introduction: Tuberculosis (TB) remains one of the leading infectious causes of death worldwide, and India is among the countries with the highest TB burden. TB control is facing several roadblocks in our country with the rapid development of multidrug-resistant (MDR) as well as extensively drug-resistant TB (XDR) and as an after-effect of the global COVID-19 pandemic. With the target of TB elimination by 2025 (National Tuberculosis Elimination Program, NTEP), there is a need that treating physicians in our country be well aware of MDR-TB and be able to diagnose and treat it at an appropriate time. The present study is conducted to explore the knowledge levels, attitudes, and practices concerning MDR-TB amongst healthcare professionals working in different healthcare sectors.Methods: A total of 250 allopathic medical practitioners (Bachelor of Medicine and Bachelor of Surgery [MBBS], specialists, and superspecialists) working in any sector (private or government), who are directly involved in managing any form of TB patient and are willing to undertake the assessment, were included in this online questionnaire-based survey that was circulated using various social media platforms like WhatsApp, Facebook, Linked In, and Gmail. Responses to the questionnaires created in Google Forms were analyzed by capturing data in a Microsoft Excel® spreadsheet for further statistical analysis. The data were analyzed using multiple measures of dispersion and cross-tabulations.Results: Among the 250 participants, most of the participants had encountered MDR-TB in their clinical practice, and the majority believe that MDR-TB is a rising problem. Although 88% of the participants did a GeneXpert assay before the start of anti-tubercular therapy (ATT), three-fourths of the participants knew that the assay detects the MTB genome and rifampicin resistance. MDR-TB was suspected in participants after no clinical improvement was observed after 3-6 weeks of a trial of ATT. Two-thirds of the participants knew that linezolid is currently being used as a second-line drug for the treatment of MDR-TB. The respondents in our survey mostly do not themselves treat MDR-TB and refer the patients to an MDR-TB center or a pulmonary medicine specialist. Conclusion: Healthcare practitioners (HCPs) with good knowledge levels can diagnose and treat TB patients appropriately, thus decreasing the rising MDR-TB problem, and they can educate patients and the general population about TB and the emerging MDR-TB situation. With the current level of knowledge about MDR-TB management, there is certainly an urgent need for educational and persuasive measures for the training of doctors in both the public and private sectors so as to achieve TB elimination by 2025.

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Section: Discussionmentioning

confidence: 99%

Knowledge, Attitude, and Practices Among Healthcare Practitioners in the Context of Multidrug Resistance Tuberculosis: An Appraisal to Disease Elimination

Jain¹,

Rath²,

Mohanty³

et al. 2023

Cureus

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“…2 There are concerns that private providers lack the knowledge to implement proper TB case management. [3][4][5][6] A comparison of TB management in the public and private sectors in Australia noted that private-sector patients were more likely to receive less than 4 first-line medications, but treatment outcomes were comparable between sectors. 6 A study in Nigeria to assess the quality of TB diagnosis and treatment showed that in 2008, when private sector involvement in TB control was still in its early stage, private physicians who had reported managing TB clients had poor knowledge and practice of TB management.…”

Section: Introductionmentioning

confidence: 99%

How Do Private Providers Unaffiliated With the Nigeria National TB Program Diagnose and Treat Drug-Susceptible TB Patients? A Cross-Sectional Study

Adepoju¹,

Adelekan

Etuk

et al. 2022

Glob Health Sci Pract

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A majority of Nigerians seek TB care from the private sector, yet private providers who are not affiliated with the National TB Program (NTP) do not receive training on guidelines for diagnosis and treatment.n Nearly 40% of private unaffiliated providers we surveyed self-reported using acid-fast bacilli for TB diagnosis. However, a much larger percentage used 5 other TB testing approaches not approved by the NTP to make a definitive diagnosis. n Only 32.4% of providers surveyed prescribed the correct drug regimens. Five of the treatment regimens reported in our study contained streptomycin, which is against NTP recommendation.

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Factors affecting the utilization of Xpert MTB/RIF assay among TB clinic health workers in Addis Ababa

Agonafir

Assefa

Girmachew

et al. 2018

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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IntroductionThe diagnostic accuracy of Xpert MTB/RIF is well documented but underutilization is a major challenge in most high burden countries. This appears to be linked with insufficient knowledge of health professionals of using the tool. However, this has not been well studied.ObjectiveOur objective was to assess the knowledge of health professionals on Xpert MTB/RIF assay and associated factors in detecting TB/TB drug resistance.MethodsAn institution based cross–sectional study was conducted from April 4 to June 5, 2015, in Addis Ababa that involved 209 healthcare providers working in TB clinics. Structured questionnaire through self-administered interview technique was used to collect the data. We asked them about Xpert on whether they are aware of its place in TB diagnosis, when and for whom it shall be used, its role in treatment monitoring, result interpretation and patient's registration that are diagnosed by Xpert MTB/RIF. We used binary logistic regression analysis to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations.ResultsOf the 209 participants interviewed, the majority 151 (72.2%) were nurses. More than a half of the respondents 114 (54.6%) had poor knowledge. Health professionals with age above 35 years (AOR = 6.253, 95% CI (1.1995, 19.604)) and those who read the Xpert guideline (AOR = 4.231, 95% CI (2.011, 8.900)) were more likely to have good knowledge on Xpert.Conclusion and recommendationThis study revealed that the overall magnitude of knowledge status was found to be low. Health workers above 35 years and those who read the guideline on Xpert had higher knowledge status on Xpert. Distribution of national guideline on Xpert and assigning experienced clinicians in TB DOTs clinics are recommended.

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Adherence of the private sector to national tuberculosis guidelines in the Islamic Republic of Iran, 2001-02

Cited by 8 publications

References 8 publications

Knowledge, Attitude, and Practices Among Healthcare Practitioners in the Context of Multidrug Resistance Tuberculosis: An Appraisal to Disease Elimination

Knowledge, Attitude, and Practices Among Healthcare Practitioners in the Context of Multidrug Resistance Tuberculosis: An Appraisal to Disease Elimination

How Do Private Providers Unaffiliated With the Nigeria National TB Program Diagnose and Treat Drug-Susceptible TB Patients? A Cross-Sectional Study

Factors affecting the utilization of Xpert MTB/RIF assay among TB clinic health workers in Addis Ababa

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