Evaluation of the implementation of directly observed treatment short course by private medical practitioners in the management of tuberculosis in Enugu, Nigeria

Abstract

This study was carried out to evaluate the use of directly observed treatment short course by private medical
practitioners in the management of tuberculosis (TB) as a step towards achieving public-private mix strategy in Enugu,
Nigeria. A self-administered questionnaire was used to collect data from all private practitioners practicing in Enugu
North Local Government Area. Three hundred and forty doctors were studied and among these 64 (18.8%) managed
more than 5 tuberculosis cases every month. Most of the doctors, 310 (91.2%) based their diagnosis of tuberculosis on
sputum acid-fast bacilli result. However, none of the private practitioners used the appropriate drug combination, dosage
and duration. Most of the private practitioners (61.5%) did not follow up their tuberculosis patients and a larger
percentage (72.1%) did not have facilities for tracing defaulters. Although 321 (94.4%) of private practitioners would like
to be provided with information about national tuberculosis control programme (NTP) only 32 (26.2%) of them had ever
participated in a continuing medical education (CME) on tuberculosis. In conclusion, although private practitioners
manage a reasonable number of tuberculosis patients their management is often inappropriate and not in line with NTP
guidelines. As part of the efforts to achieving a successful public-private mix in TB control, private practitioners should
undergo CME on national tuberculosis control programme. It is important that the government should routinely monitor
and evaluate the management of TB by the private practitioners.

Keywords: Tuberculosis, private practitioners, treatment strategy, Nigeria

Tanzania Health Research Bulletin Vol. 8 (2) 2006: pp. 86-89