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Dr Ashish Yadav
 

Dr Ashish Yadav

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    Dr Ashish Yadav Dr Ashish Yadav Presentation Transcript

    • Management of Pulmonary Tuberculosis by Private Practitioners in Meerut
      AshishYadav, S. K. Garg, H. Chopra,
      S. K. Bajpai, T. Bano, S. Jain, A. Kumar
      Department of Community Medicine
      L.L.R.M. Medical College, Meerut
    • Background
      A large segment of the population seek health care from the private sector that includes private medical practitioners.
      Patients seeking health care from these service providers include a significant proportion of tuberculosis patients who are deprived of free TB services provided under RNTCP.
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      Dr Ashish Yadav
    • The private health sector did not have a strong presence when the National Tuberculosis Programme was designed.
      Over the years, however, the private sector has outgrown the public health sector, and today three-quarters of India’s health expenditure takes place in the private sector.
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    • About 80% of the qualified medical practitioners in the country are in the private sector and more than half of TB cases seek treatment from private practitioners.
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    • Objective
      To assess the management modalities of Pulmonary Tuberculosis by
      private practitioners of
      Meerut.
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    • Material and Methods
      A cross sectional study was undertaken covering all the private practitioners registered under IMA, Meerut Branch.
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      Private
      Practitioners
    • Among a total of 171 registered practitioners, only 154 practitioners participated in the study giving an overall response rate of 90.1% (154 out of 171).
      They were interviewed by a predesigned and pretested questionnaire about the various diagnostic & treatment modalities of pulmonary TB practiced by them.
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    • RESULTS
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    • Qualification of the Private Practitioners( n = 154 )
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    • Distribution of the private practitioners by their experience
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    • RNTCP Training of private practitionersin past 5 years
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    • First priority investigation used for diagnosisin relation to RNTCP training
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      χ2 =9.485 , df = 2 , p < 0.01
    • Awareness of categorization among Private Practitioners
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    • Practice of Categorization
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    • ATT regimens used by the Private Practitioners
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      • A total of 154 private practitioners used 53
      different treatment regimens to treat
      pulmonary TB cases.
    • ATT administration in accordancewith RNTCP
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    • Drug combinations used by the private practitioners for Intensive Phase
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    • Use of Sputum Smear Examination as a criteria to stop the treatment
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    • Parameters used as a criteria to stop treatment of tuberculosis
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    • Conclusion
      Sputum examination is being neglected for diagnosis & as a criterion for stopping treatment.
      There is marked reliance on X-ray among private practitioners for management of Pulmonary TB.
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    • There is an urgent need to
      strengthen the RNTCP
      training of the private
      practitioners and sensitize
      them for their reorientation
      towards standard management
      of tuberculosis.
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      Dr Ashish Yadav