India: Report each TB case to us, says health dept
Private practitioners treating tuberculosis patients will now have to report each case to the state health department. The aim is to improve private doctors' participation as well as to ensure appropriate and effective treatment of the disease.
"Private doctors have been working with the state health department in reporting tuberculosis cases, but their number has always been minuscule. We have started senisitising doctors about the tuberculosis treatment and drug regimen on a war footing now. As a result, we could enroll 1,000 doctors in the last month alone. Now, we have sent a circular to all private doctors asking them to join us in fighting the tuberculosis. We hope the number will swell in the next few months," Pradeep Gaikwad, joint director (TB), state health department told TOI on Monday.
Besides, the aim is also to put those patients who left treatment midway due to huge expenses involved in seeking it at private hospitals and to senitise doctors in prescribing the second line of anti-TB drugs, Gaikwad said.
The state has 1 lakh allopath doctors. Besides, two to three lakh doctors from ayurveda and homeopathy also practise. "Our aim is to enroll as many of them as possible in the next few months," Gaikwad said. Till recently, a total 4,500 private doctors were enrolled with the state health department for reporting the cases.
"There are only 15,000 private doctors in India who report cases of TB under them to respective state health departments. Among them, Maharashtra has been leading the front with these 4,500 doctors. But considering, the huge number of doctors, the state has, the number has been always dismal. The circular to all the practising doctors in the state will improve their participation as the first reference of medical advice for anyone is a neighbourhood doctor," Gaikwad said.
A Mumbai-based study, published in the medical research journal Plos One, has said that the correct drug regimen, as specified in the Revised National Tuberculosis Control Programme (RNTCP), is not being followed by general practitioners thus increasing the burden of drug-resistant tuberculosis.
The survey, which sought responses from 106 general practitioners, including 46 allopaths and 60 others trained in alternative systems of medicine like homeopathy, ayurveda and unani, found that only six of the respondents wrote a prescription with a correct drug regimen for TB treatment.
Just three doctors among the respondents could write an appropriate prescription for treatment of multi-drug resistant (MDR) TB. All 106 doctors prescribed 63 different drug regimens while no practitioner wrote an intermittent drug regimen currently recommended by the RNTCP. Experts from the department of respiratory diseases at PD Hinduja National Hospital and Medical Research Centre, Mumbai and WHO carried out the study.
The study was called Tuberculosis Management by Private Practitioners in Mumbai, India: Has Anything Changed in Two Decades?
It revisited the concerns that an earlier study of the same issue at Dharavi in Mumbai in 1991 had raised. These results showed that 100 practitioners had prescribed 80 different drug regimens for treatment of TB. The study highlighted the magnitude of poor prescribing practices of private medical practitioners. Last year's study found that little had changed in 20 years. Over half the prescriptions in the survey were still inappropriate when compared with the observations recorded in the 1991 survey.
