الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
The persistence of infectious PTB as a major public health problem results from the presence of individuals with active infection in whom the disease remains undiagnosed or in whom a delay in diagnosis occurs. The varied quality of healthcare provided by public and private sectors, and the failure of some healthcare providers to diagnose tuberculosis promptly and to ensure the delivery of adequate treatment are two major factors contributing to the poor control of tuberculosis.
The aim of this work was to study the way non pulmonologists in Qena governorate deal with tuberculosis cases as regards detection, diagnosis, treatment and to what extent the management conforms to the national and international standards of care of tuberculosis.
One hundred and seventy eight( 178) physicians were included in this study of different specialties (68 GP, 28 internists, 20 pediatricians, 20 general surgery physicians, 19 gynecologists & obstetricians, 9orthopedics, 7urologists, 5 neurologists and 2 neurosurgery physicians), 152 of them were males and 26 were females with mean age 39±9.7 years . Their medical graduations were 76 MBBCH, 61 Diploma, 37 Master and 4 Medical Doctorate. Sixty five (36.5%) of them were working in primary health care units and ninety two(51.7%) were working both in general and private sectors.
Ninety two percent of the inquired physicians perceived the problem of TB in Egypt as prevalent but a controlled one . Thirty one and half (31.5%) of the studied populations did manage Tb cases (59% pulmonary TB and 48.2% extra pulmonary TB), in the year prior to the study. The average number of cases assessed by the physicians was less than 5 cases/year (85.7%), five-ten cases/year (10,7%), more than 10 cases/year (3.5%).
Of those who managed cases with TB 26.8% preferred to refer suspect cases to chest hospital or chest physicians, while 73.2% continued investigation to diagnose the disease. The latter physicians, confirmed the diagnosis histopathologically or bacteriologically in 48.8% of cases, relied upon radiological findings with or without non specific test in 34%, and relied on clinical assessment with or without non specific laboratory results in 17 % of cases
Of the physicians who investigated for the disease, only 9 physicians continued management and prescribed anti TB medications. All were specialized physicians, and 55.5% received their post graduate study in Assuit University. The prescribed regimens, though acceptable, were not uniform and not conforming to national guidelines in most of cases. Eighty three percent of the inquired physicians don’t know about Egyptian guidelines for management of tuberculosis
None of managing physicians did notify health authorities of suspect or confirmed TB cases. No isolation measures were taken and no contact survey was performed.
57% of inquired physician chose medical conferences or workshops as their preferred method to update their knowledge and to get information about TB.