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Dr Ashish Yadav

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Dr Ashish Yadav

  1. 1. Management of Pulmonary Tuberculosis by Private Practitioners in Meerut<br />AshishYadav, S. K. Garg, H. Chopra,<br />S. K. Bajpai, T. Bano, S. Jain, A. Kumar<br />Department of Community Medicine<br />L.L.R.M. Medical College, Meerut<br />
  2. 2. Background<br />A large segment of the population seek health care from the private sector that includes private medical practitioners.<br />Patients seeking health care from these service providers include a significant proportion of tuberculosis patients who are deprived of free TB services provided under RNTCP.<br />2<br />10/31/2010<br />Dr Ashish Yadav<br />
  3. 3. The private health sector did not have a strong presence when the National Tuberculosis Programme was designed. <br />Over the years, however, the private sector has outgrown the public health sector, and today three-quarters of India’s health expenditure takes place in the private sector.<br />3<br />10/31/2010<br />Dr Ashish Yadav<br />
  4. 4. About 80% of the qualified medical practitioners in the country are in the private sector and more than half of TB cases seek treatment from private practitioners.<br />4<br />10/31/2010<br />Dr Ashish Yadav<br />
  5. 5. Objective<br />To assess the management modalities of Pulmonary Tuberculosis by<br />private practitioners of<br />Meerut.<br />5<br />10/31/2010<br />Dr Ashish Yadav<br />
  6. 6. Material and Methods<br />A cross sectional study was undertaken covering all the private practitioners registered under IMA, Meerut Branch.<br />6<br />10/31/2010<br />Dr Ashish Yadav<br />Private <br />Practitioners<br />
  7. 7. Among a total of 171 registered practitioners, only 154 practitioners participated in the study giving an overall response rate of 90.1% (154 out of 171). <br />They were interviewed by a predesigned and pretested questionnaire about the various diagnostic & treatment modalities of pulmonary TB practiced by them.<br />7<br />10/31/2010<br />Dr Ashish Yadav<br />
  8. 8. RESULTS<br />8<br />10/31/2010<br />Dr Ashish Yadav<br />
  9. 9. Qualification of the Private Practitioners( n = 154 )<br />9<br />10/31/2010<br />Dr Ashish Yadav<br />
  10. 10. Distribution of the private practitioners by their experience<br />10/31/2010<br />Dr Ashish Yadav<br />10<br />
  11. 11. RNTCP Training of private practitionersin past 5 years<br />10/31/2010<br />Dr Ashish Yadav<br />11<br />
  12. 12. First priority investigation used for diagnosisin relation to RNTCP training<br />10/31/2010<br />12<br />χ2 =9.485 , df = 2 , p < 0.01<br />
  13. 13. Awareness of categorization among Private Practitioners<br />13<br />10/31/2010<br />Dr Ashish Yadav<br />
  14. 14. Practice of Categorization<br />14<br />10/31/2010<br />Dr Ashish Yadav<br />
  15. 15. ATT regimens used by the Private Practitioners<br />15<br />10/31/2010<br />Dr Ashish Yadav<br /><ul><li> A total of 154 private practitioners used 53</li></ul> different treatment regimens to treat<br /> pulmonary TB cases.<br />
  16. 16. ATT administration in accordancewith RNTCP<br />16<br />10/31/2010<br />Dr Ashish Yadav<br />
  17. 17. Drug combinations used by the private practitioners for Intensive Phase<br />17<br />10/31/2010<br />Dr Ashish Yadav<br />
  18. 18. Use of Sputum Smear Examination as a criteria to stop the treatment<br />18<br />10/31/2010<br />Dr Ashish Yadav<br />
  19. 19. Parameters used as a criteria to stop treatment of tuberculosis<br />19<br />10/31/2010<br />Dr AshishYadav<br />
  20. 20. Conclusion<br />Sputum examination is being neglected for diagnosis & as a criterion for stopping treatment. <br />There is marked reliance on X-ray among private practitioners for management of Pulmonary TB. <br />20<br />10/31/2010<br />Dr Ashish Yadav<br />
  21. 21. There is an urgent need to<br />strengthen the RNTCP<br /> training of the private <br /> practitioners and sensitize<br /> them for their reorientation<br /> towards standard management<br /> of tuberculosis.<br />21<br />10/31/2010<br />Dr Ashish Yadav<br />