期刊论文详细信息
BMC Research Notes
The perspective of private practitioners regarding tuberculosis case detection and treatment delay in Amhara Region, Ethiopia: a cross-sectional study
Gunnar A Bjune3  Carol-Holm Hansen1  Solomon A Yimer2 
[1] Norwegian Institute of Public Health, Postbox 4404, Nydalen 0403, Oslo, Norway;Amhara Regional State Health Bureau, P.O.Box 495, Bahir Dar, Ethiopia;Institute of Health and Society, Section for International Health, Faculty of Medicine, University of Oslo, Norway
关键词: Ethiopia;    treatment delay;    private practitioners;    tuberculosis;   
Others  :  1167301
DOI  :  10.1186/1756-0500-4-285
 received in 2011-04-18, accepted in 2011-08-11,  发布年份 2011
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【 摘 要 】

Background

Engaging all health care providers in tuberculosis (TB) control has been incorporated as an essential component of World Health Organization's Stop TB Strategy and the Stop TB Partnership's global plan 2006-2015. Ethiopia has a growing private health sector. The objective of the present study was to investigate the role of private practitioners (PPs) in TB case detection and assess their perspectives on TB treatment delay in Amhara Region, Ethiopia.

Results

A cross-sectional study among 112 PPs selected from private health facilities (PHF) in the region was conducted. The study was carried out between May and August 2008 and data was collected using a semi-structured questionnaire. Group differences were analyzed using one-way Anova test and a p-value of < 0.05 was considered statistically significant.

In this study, PPs saw a median of 12 TB suspects and 1.5 patients a week. The mean number of TB suspects and patients seen varied significantly among the different professions with p < 0.009 and p < 0.004, respectively. Pulmonary TB patients referred by PPs were delayed up to one week before starting treatment at government health facilities. A 22% increase in the detection of smear-positive TB cases may be achieved by involving all PHFs in the TB control program in the region. Nineteen percent of the PPs indicated that TB patients' prior attendance to non medical health providers resulted in complication of disease and increased treatment delay for TB.

Conclusion

PPs manage a substantial number of TB suspects and patients in Amhara Region, Ethiopia. The GHF delay observed among TB patients referred by PPs to GHF is unnecessary. Expanding PPM-DOTS in the region and improving the quality of TB care at both government and private health facilities reduces treatment delay and increases TB case detection.

【 授权许可】

   
2011 Yimer et al; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Uplekar M: Involving private health care providers in delivery of TB care: global strategy. Tuberculosis 2003, 83:156-164.
  • [2]WHO: The Stop TB strategy. [http://www.who.int/tb/strategy/en/] webcite [accessed 2010 Jun 03]
  • [3]Uplekar M, Raviglione M, Pathania V: Private practitioners and public health: weak links in tuberculosis control. Lancet 2001, 358:912-916.
  • [4]Public-Private Mix for DOTS: Towards scaling up. Report from the 3rd meeting of the PPM Subgroup for DOTS expansion. In WHO/HTM/TB/2005.356. Geneva: World Health Organization; 2005.
  • [5]Floyd K, Arora VK, Murthy KJR, Lönnroth K, Singla N, Akbar Y, Zignol M, Uplekar M: Cost and cost-effectiveness of public and private sector collaboration in tuberculosis control: evidence from India. Bulletin of WHO 2006, 84:437-45.
  • [6]World Health Organization: Global tuberculosis control-epidemiology, strategy and financing: profiles of high burden countries. Annual report NO. WHO/HTM/TB/2008.393. Geneva 2008.
  • [7]Amhara Regional State Health Bureau: Annual Health Service Report. Bahir Dar, Ethiopia 2008.
  • [8]Shimeles E, Assefa A, Yamuah L, Tilahun H, Engers H: Knowledge and practice of private practioners in TB control in Addis Ababa. Int J tubrc lung dis 2006, 10:172-1177.
  • [9]Yimer S, Bjune G, Alene G: Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross-sectional study. BMC Infect Dis 2005, 5:112. BioMed Central Full Text
  • [10]The United States Agency for International Development (USAID): Final evaluation: The private sector program in Ethiopia [http://www.ghtechproject.com/Attachment.axd?ID=65d87be9-5166-4011-9322] webcite 2009.
  • [11]National Tuberculosis and Leprosy Prevention and Control Program, Manual Addis Ababa, Ethiopia: Ministry of Health; 2002:27-33.
  • [12]Mahendradhata Y, Utarini A, Lazuardi U, Boelaert M, Stuyft PV: Private practitioners and tuberculosis case detection in Jogjakarta, Indonesia: actual role and potential. Tropical Medicine and International Health 2007, 12:1218-1224.
  • [13]Ahmed M, Fatmi Z, Ali S, Ahmed J, Ara N: Knowledge, attitude and practice of private practioners regarding TB-DOTS in a rural district of Sindh, Pakistan. J Ayub Med Coll Abbottabad 2009, 21.
  • [14]Portero JL, Rubio M: Private practitioners and tuberculosis control in the Philippines: strangers when they meet? Tropical Medicine and International Health 2003, 8:329-335.
  • [15]Hooi LN: Case-finding for pulmonary tuberculosis in Penang. Med J Malaysia 1994, 49:223-230.
  • [16]Masjedi MR, Cheragvandi A, Hadian M, Velayati AA: Reasons for delay in the management of patients with pulmonary tuberculosis. East Mediterr Health J 2002, 8:324-329.
  • [17]Ward J, Siskind V, Konstantinos A: Patient and health care system delays in Queensland tuberculosis patients, 1985-1998. Int J Tuberc Lung Dis 2001, 5:1021-1027.
  • [18]Storla DG, Yimer S, Bjune GA: A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health 2008, 8:15. BioMed Central Full Text
  • [19]Yimer S, Holm-Hansen C, Yimaldu T, Bjune G: Health care seeking among pulmonary tuberculosis suspects and patients in rural Ethiopia: a community-based study. BMC Public Health 2009, 9:454. BioMed Central Full Text
  • [20]Demissie M, Zenebre B, Berhane Y, Lindtjørn B: A rapid survey to determine the prevalence of smear-positive tuberculosis in Addis Ababa. Int J Tuberc Lung Dis 2002, 6:580-584.
  • [21]Yimer S, Holm-Hansen C, Yimaldu T, Bjune G: Evaluating an active case-finding strategy to identify smear-positive tuberculosis in rural Ethiopia. Int J Tuberc Lung Dis 2009, 13:1399-404.
  • [22]Central Statistics Authority: The 2007 population and housing census of Ethiopia: Results for Amhara Region, Addis Ababa, Ethiopia. 2009.
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