Yimer Solomon A, Holm-Hansen Carol, Bjune Gunnar
Norwegian Institute of Public Health, Oslo, Norway.
J Infect Dev Ctries. 2012 Jan 12;6(1):13-9. doi: 10.3855/jidc.1927.
Ethiopia has a growing private health sector. In recent years, the directly observed treatment short course (DOTS) strategy was initiated in selected private health facilities in the country. The objective of the present study was to assess knowledge and practice of private practitioners in tuberculosis (TB) control in Amhara Region, Ethiopia.
An institution-based cross-sectional study was conducted among 112 private practitioners selected from all private health facilities in the region. The study was conducted between May and August 2008 and data was collected using a semi-structured questionnaire. Group differences were analyzed using the chi-square test.
Fifty-nine (52.7%) of the private practitioners suspected TB in patients with three weeks' duration of cough. Only 37 (33.0%) of the private practitioners were able to precisely list the correct treatment regimens for all categories as recommended in the National Tuberculosis and Leprosy Control Program guidelines. The correct frequency of TB treatment monitoring was provided by 44 (50%) of the respondents. Overall 44 (39.3%) of the private practitioners did not have satisfactory knowledge about the directly observed treatment short course (DOTS) strategy. Those who attended DOTS training during the two years prior to the survey were more likely to have satisfactory knowledge compared to those who did not receive training (OR 4.45, 95% CI: 1.33, 14.87, p < 0.02).
A significant proportion of private practitioners did not have satisfactory knowledge and practice about DOTS. The provision of regular DOTS refresher courses improves TB management for patients in the region.
埃塞俄比亚的私立卫生部门在不断发展。近年来,该国部分私立医疗机构启动了直接观察短程治疗(DOTS)策略。本研究的目的是评估埃塞俄比亚阿姆哈拉地区私立执业医师在结核病控制方面的知识和实践情况。
在该地区所有私立医疗机构中选取112名私立执业医师进行基于机构的横断面研究。研究于2008年5月至8月进行,使用半结构化问卷收集数据。采用卡方检验分析组间差异。
59名(52.7%)私立执业医师怀疑咳嗽三周的患者患有结核病。只有37名(33.0%)私立执业医师能够准确列出国家结核病和麻风病控制项目指南中推荐的所有类型的正确治疗方案。44名(50%)受访者提供了正确的结核病治疗监测频率。总体而言,44名(39.3%)私立执业医师对直接观察短程治疗(DOTS)策略的了解并不令人满意。与未接受培训的人相比,在调查前两年内参加过DOTS培训的人更有可能具备令人满意的知识(比值比4.45,95%置信区间:1.33,14.87,p<0.02)。
相当一部分私立执业医师对DOTS的知识和实践并不令人满意。提供定期的DOTS进修课程可改善该地区患者的结核病管理。