Evaluation of the implementation of directly observed treatment short course by private medical practitioners in the management of tuberculosis in Enugu, Nigeria

This study was carried out to evaluate the use of directly observed treatment short course by private medical practitioners in the management of tuberculosis (TB) as a step towards achieving public-private mix strategy in Enugu, Nigeria. A self-administered questionnaire was used to collect data from all private practitioners practicing in Enugu North Local Government Area. Three hundred and forty doctors were studied and among these 64 (18.8%) managed more than 5 tuberculosis cases every month. Most of the doctors, 310 (91.2%) based their diagnosis of tuberculosis on sputum acid-fast bacilli result. However, none of the private practitioners used the appropriate drug combination, dosage and duration. Most of the private practitioners (61.5%) did not follow up their tuberculosis patients and a larger percentage (72.1%) did not have facilities for tracing defaulters. Although 321 (94.4%) of private practitioners would like to be provided with information about national tuberculosis control programme (NTP) only 32 (26.2%) of them had ever participated in a continuing medical education (CME) on tuberculosis. In conclusion, although private practitioners manage a reasonable number of tuberculosis patients their management is often inappropriate and not in line with NTP guidelines. As part of the efforts to achieving a successful public-private mix in TB control, private practitioners should undergo CME on national tuberculosis control programme. It is important that the government should routinely monitor and evaluate the management of TB by the private practitioners. _______________________________________________________________________________________________