EMRO NTP MANEGERS MEETING IN DAMASCUS 15170902

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EMRO NTP MANEGERS MEETING IN DAMASCUS 15-17/09/02

• Dr. Bashir A Suleiman
• TB COORDINATOR, WHO HARGEISA, SOMALILAND.

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Investigator Co-investigators

• B. A. Suleiman1, A. I. Houssein2, F. Mehta3, S.G.
  Hinderaker4
• 1 WHO Somalia, Hargeisa, Somaliland 2 Hargeisa
  General Hospital, Hargeisa, Somaliland 3 WHO
  Somalia, Nairobi, Kenya 4 Center for
  International Health, University of Bergen, Norway

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Setting

• Are medical practitioners in Somaliland following
  the national guidelines for tuberculosis control
  in Somaliland in diagnosis and case management of
  pulmonary tuberculosis?

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Objective

• To assess the knowledge and practices of medical
  practitioners in diagnosis and management of
  tuberculosis in Somaliland.

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Methodology

• A cross-sectional study among medical
  practitioners registered in the Ministry was done
  from July to November 2001.
• The doctors were interviewed with a structured
  questionnaire concerning their knowledge and
  practice of diagnosis and management of TB.

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Results

• Among 100 registered doctors, 53 were
  interviewed. 32 doctors (64) had treated TB
  patients during the prior 12 months but only one
  had notified the case to the National TB Program
• 33 (66) of all the doctors knew the most
  important symptoms of tuberculosis, and 32 (60)
  doctors indicated sputum smear microscopy as the
  most important diagnostic test.
• 32 (60) doctors indicated sputum smear
  microscopy as the most important diagnostic test
• Only four doctors prescribed the correct regimen,
  and only seven advocated direct observation of
  drug taking

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Conclusion

• TB patients are seen and treated in private
  sector, and few doctors follow the guidelines of
  the National TB Program in Somalia

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Recommendation

• Training for medical practitioners in diagnosis
  and case management of TB is needed to improve
  tuberculosis control in Somaliland
• The distribution of NTP guidelines to all medical
  practitioners in Somaliland.

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TABLE 1. Characteristics of study participants,
Somaliland, 2002

• Total number of respondents 53
• Age lt 40 10 40-49 36 gt 50 07
• Sex Male 52 Female 01
• Year of Graduation before 1980 16 1980-89
  32 1990-2001 05
• Post-graduate training (specialist) 20
• Work only private 17 only public 07
  Public Private 29
• Treated TB patient last 12 months ( yes) 32
  (64

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TABLE 1. Characteristics of study participants,
Somaliland, 2002

• Total number of TB patients seen last year 1326
  (25)
• Smpos PTB (mean per doctor) 142 (3)
• Smneg PTB (mean per doctor 834 (16)
• EPTB (mean per doctor) 350 (7)
• Notified TB patients last 12 months ( yes) 1

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Table 2. The knowledge and practice in diagnosis
and case management of TB among medical doctors
in Somaliland, 2002.

• All Specialists
• Total 53 (100) 20 (100)
• Correct symptoms 33 (66) 14 (70)
• Correct priority of diagnostic test 32
  (60) 10 (50)
• Correct regimen 4 (7) 1 (5)
• Direct observation of drug taking 7 (13) 1
  (5)
• Correct action to patients
• missing their appointments 8 (15) 2 (10)
• Submitting reports 2 (4) 1 (5)