Setting: Implementation study in private health facilities in an Indian metropolis.
Objectives: Improve Tuberculosis (TB) care by private practitioners (PPs).
Methods: PPs from a defined city area were imparted short training in TB care and linkages made with public facilities; subsequent practices were recorded.
Results: Of 364 presumptive TB patient records, 70 (19.3%) did not conform to its definition. Of the conforming, 174 (59.2%) had presumptive pulmonary TB (PTB), 53 (18%) presumptive extra-pulmonary (EPTB) and 67 (24%) had both. Of conforming presumptive PTB, most underwent Chest X-ray and sputum examination in private laboratories. Tissue based diagnostics were not advised for most presumptive EPTB patients. Of 101 cases diagnosed with TB, 82% were new, 23% known diabetic and 4.7% human immune deficiency virus (HIV) reactive out of 64 tested. Most were notified and initiated treatment within 15 days of diagnosis. One-fourth was prescribed standard treatment regimen and treatment was not directly observed for most. One third was initial defaulters or lost during treatment; 62% of PTB and 46% EPTB cases initiated on treatment in private were successfully treated. Of successfully treated PTB cases, 61% had undergone follow-up sputum examination.
Conclusion: Much intensified support mechanisms are needed to improve TB care in private sector.
Keywords: Notification; Private practitioners; Private-public mix; TB care.
Copyright © 2018. Published by Elsevier B.V.