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Is awareness of DOTS amoung medical practitioners in Mysore a worry ?-Mudassir Azeez Khan

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Is awareness of DOTS amoung medical practitioners in Mysore a worry ?-Mudassir Azeez Khan

  1. 1. Mysore Medical College & Research Institute, Mysore, Karnataka *Safdarjung Hospital, New Delhi   Is Awareness of DOTS among Medical Practitioners in Mysore a Worry? Mudassir Azeez Khan , Sonal Agarwal, Vinayaknagaraja, Ganraj Bhat, Ghazal Dutta, Ashwini B. R., Abhinit Kumar *
  2. 2. BACKGROUND <ul><li>RNTCP introduced in 1993 </li></ul><ul><li>March 2006 – 100% DOTS Coverage by RNTCP </li></ul><ul><li>DOTS – Major Public Health Breakthrough </li></ul>
  3. 3. OBJECTIVES <ul><ul><ul><ul><li>1. To study the extent of awareness of DOTS. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>2. To compare DOTS awareness and usage among doctors based on criteria like: </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Their graduation before or after the inclusion of DOTS in curriculum </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>The type of health centre they work in </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Their field of specialty </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>3. Impact of DOTS related myths and misconceptions among doctors. </li></ul></ul></ul></ul>
  4. 4. METHODOLOGY <ul><li>A cross-sectional comparative study </li></ul><ul><li>Subjects – 311/401 Registered Medical Practitioners in Mysore District who come across TB patients </li></ul><ul><li>Scope based Questionnaire preparation & Data Gathering </li></ul><ul><li>Statistical analysis using chi square test </li></ul>
  5. 5. THE BREAK-UP
  6. 6. WORK SET-UP
  7. 7. FIELD OF SPECIALTY
  8. 8. THE PRE- & POST- RNTCP ERA
  9. 9. BASIC INFORMATION ABOUT DOTS
  10. 10. THOSE WHO DO PRACTICE DOTS
  11. 11. WHY NOT DOTS FOR ALL?
  12. 12. THOSE WHO DO NOT PRACTICE DOTS
  13. 13. COST ESTIMATION
  14. 14. ADOPTING DOTS & MISCONCEPTIONS
  15. 15. RESULTS <ul><li>Overall Usage/Awareness of DOTS – LOW </li></ul><ul><li>Considerably low (p< 0.001) among doctors </li></ul><ul><ul><li>Graduating before inclusion of DOTS </li></ul></ul><ul><ul><li>into curriculum </li></ul></ul><ul><ul><li>Practicing in the Private Sector </li></ul></ul><ul><ul><li>Orthopedic Surgeons, Gynecologists, </li></ul></ul><ul><ul><li>Pediatricians </li></ul></ul>
  16. 16. SITUATION NOT SO DULL… <ul><li>100% of the doctors working in Government sector felt that DOTS was better than NTCP. </li></ul><ul><li>Most of the doctors who practiced DOTS felt that it was highly effective in treating TB. </li></ul>
  17. 17. CONCLUSIONS <ul><li>Communication gap between RNTCP & its implementers (doctors) </li></ul><ul><li>Need for a parallel social network to help doctors implement DOTS </li></ul><ul><li>Need for proactive involvement of medical practitioners </li></ul>
  18. 18. SUGGESTIONS <ul><li>Workshops & CMEs </li></ul><ul><li>More emphasis about DOTS in Medical Curriculum </li></ul><ul><li>Expand the scope of RNTCP to engage more doctors </li></ul><ul><li>Authorize some private hospitals & nursing homes as Microscopy Centers </li></ul>
  19. 19. SUGGESTIONS contd... <ul><li>Develop supply chain to ensure DOTS availability </li></ul><ul><li>Directory of all Medical Practitioners and a nationwide toll-free helpline </li></ul><ul><li>Education and direct involvement of nurses, health workers and pharmacists </li></ul><ul><li>Adherence to counseling of the patients </li></ul><ul><li>DOTS - Fact sheet & CD for doctors </li></ul>
  20. 20. THANK YOU RNTCP

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