Knowledge and practice of private practitioners in Baghdad on directly observed treatment short course (DOTS)‎ for management of pulmonary tuberculosis

Abstract EN

Objective: To identify knowledge and practices of private medical practitioners in Baghdad regarding the management of pulmonary tuberculosis (PTB) and compare them with the control strategy Directly Observed Treatment, Short course (DOTS) adopted by Iraqi National Tuberculosis Program (NTP).

Methods: A cross sectional survey involved private practitioners [internists and general practitioners (GP)] from different localities in Baghdad who were accessible to be interviewed (convenience sampling) during the period from November 2007 to April 2008.

The questionnaire included two sections to assess knowledge and practice regarding the management of PTB.

For practitioners stated they did not receive patients with PTB at their private clinics, their interviews did not involve the practice section.

Results: The total number of participants was 102 private practitioners (31 internists and 71 GP) with a response rate of 84.2%.

About 56% of practitioners received cases of PTB at their private clinics.

Only 24.5% of private practitioners succeeded to mention all of cough, night fever and weight loss together as important manifestations for PTB.

Around one third of practitioners mentioned the five first line anti-TB drugs.

Concerning practitioners managed cases of PTB.

Only 11% of them used serial tests of sputum analysis to confirm diagnosis of sputum positive PTB.

No one could diagnose sputum negative PTB using NTP criteria.

More than two thirds of practitioners were not correctly able to monitor for side effects of anti-TB drugs, to correctly prescribe anti-TB drugs in special situations or to follow up effectiveness of treatment.

Ninety practitioners (84.2%) educated their patients and 44% traced contacts.

Average knowledge score was 3.67±1.88 (total of ten) and average practice score was 8.70±2.15 (total of twenty).

Conclusions: Knowledge and practice of private practitioners in Baghdad deviate far away from NTP guidelines, while they should play an important role in tuberculosis control.