印度迈索尔市的结核病强制通报：我们听到私人执业医生的诉求了吗？
Mandatory TB notification in Mysore city, India: Have we heard the private practitioner's plea?
作者信息
Singh Chadha Sarabjit, Burugina Nagaraja Sharath, Trivedi Archana, Satapathy Sachi, N M Devendrappa, Devi Sagili Karuna
机构信息
International Union against Tuberculosis and Lung Disease, South-East Asia Regional Office, Qutub institutional area, Hauz Khas, New Delhi, 110016, India.
Department of Community Medicine, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore, Karnataka, 560010, India.
出版信息
BMC Health Serv Res. 2017 Jan 3;17(1):1. doi: 10.1186/s12913-016-1943-z.
BACKGROUND
The Government of India, made TB notification by private healthcare providers mandatory from May 2012 onwards. The National TB Programme developed a case based web based online reporting mechanism called NIKSHAY. However, the notification by private providers has been very low. We conducted the present study to determine the awareness, practice and anticipated enablers related to TB notification among private practitioners in Mysore city during 2014.
METHODS
A cross-sectional study was conducted among private practitioners of Mysore city in south India. The private practitioners in the city were identified and 258 representative practitioners using probability proportional to size were interviewed using semi-structured questionnaire.
RESULTS
Among the 258 study participants, only 155 (60%) respondents agreed to a detailed interview. Among those interviewed, 141 (91%) were aware that TB is a notifiable disease; however 127 (82%) of them were not aware of process of notification and NIKSHAY. Only one in six practitioners was registered in NIKSHAY, while one in three practitioners are notifying without registration. The practitioners expected certain enablers from the programme like free drugs, training to notify in NIKSHAY and timely feedback. 74 (47%) opined that notification should be backed by legal punitive measures.
CONCLUSION
The programme should develop innovative strategies that provide enablers, address concerns of practitioners while having simple mechanisms for TB notification. The programme should strengthen its inherent capacity to monitor TB notification.
背景
印度政府自2012年5月起强制要求私立医疗服务提供者进行结核病通报。国家结核病规划制定了一种基于病例的网络在线报告机制，称为“尼凯什”（NIKSHAY）。然而，私立提供者的通报率一直很低。我们开展了本研究，以确定2014年迈索尔市私立从业者中与结核病通报相关的知晓情况、做法及预期的推动因素。
方法
在印度南部迈索尔市的私立从业者中开展了一项横断面研究。确定了该市的私立从业者，并使用按规模大小成比例概率抽样法，对258名有代表性的从业者进行了半结构化问卷调查。
结果
在258名研究参与者中，只有155名（60%）受访者同意接受详细访谈。在接受访谈的人中，141名（91%）知晓结核病是一种应通报的疾病；然而，其中127名（82%）不了解通报流程和“尼凯什”系统。每六名从业者中只有一人在“尼凯什”系统中注册，而每三名从业者中有一人在未注册的情况下进行通报。从业者期望该规划能提供一些推动因素，如免费药品、关于在“尼凯什”系统中通报的培训以及及时反馈。74名（47%）认为通报应有法律惩罚措施作为后盾。
结论
该规划应制定创新策略，提供推动因素，解决从业者的担忧，同时具备简单的结核病通报机制。该规划应加强其监测结核病通报的内在能力。
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