ArticlePloS one2016
How Do Urban Indian Private Practitioners Diagnose and Treat Tuberculosis? A Cross-Sectional Study in Chennai.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 26 citations in OpenAlex.
- India's private sector engagement model improved TB notification and drug uptake.Public health action · 2026Article
- Implementing a chest X-ray artificial intelligence tool to enhance tuberculosis screening in India: Lessons learned.PLOS digital health · 2023Article
- Changing patterns of household transmission of tuberculosis in an eastern state of India: The impact of COVID19 pandemic.The Indian journal of tuberculosis · 2022Article
- Gaps and Interventions across the Diagnostic Care Cascade of TB Patients at the Level of Patient, Community and Health System: A Qualitative Review of the Literature.Tropical medicine and infectious disease · 2022Review
- How much do Indians pay for tuberculosis treatment? A cost analysis.Public health action · 2020Article
- A narrative review of gaps in the provision of integrated care for noncommunicable diseases in India.Public health reviews · 2020Review
- Successfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India.Global health, science and practice · 2019Article
- Tuberculosis patients not covered by treatment in public health services: findings from India's National Family Health Survey 2015-16.Tropical medicine & international health : TM & IH · 2018Article
- Comparing tuberculosis management under public and private healthcare providers: Victoria, Australia, 2002-2015.BMC infectious diseases · 2017Article
- Use of Rapid, Point-of-Care Assays by Private Practitioners in Chennai, India: Priorities for Tuberculosis Diagnostic Testing.PloS one · 2016Article
- Assessing the Status of Mandatory Tuberculosis Case Notification among Private Practitioners in Urban Puducherry.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
- Enhancing the role of private practitioners in tuberculosis prevention and care activities in India.Lung India : official organ of Indian Chest SocietyReview
- Knowledge of Private Practitioners Regarding Revised National Tuberculosis Control Program- A Cross-Sectional Study from the Haryana state of India.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
settingPrivate practitioners are frequently the first point of healthcare contact for patients with tuberculosis (TB) in India. Inappropriate TB management practices among private practitioners may contribute to delayed TB diagnosis and generate drug resistance. However, these practices are not well understood. We evaluated diagnostic and treatment practices for active TB and benchmarked practices against International Standards for TB Care (ISTC) among private medical practitioners in Chennai.
designA cross-sectional survey of 228 practitioners practicing in the private sector from January 2014 to February 2015 in Chennai city who saw at least one TB patient in the previous year. Practitioners were randomly selected from both the general community and a list of practitioners who referred patients to a public-private mix program for TB treatment in Chennai. Practitioners were interviewed using standardized questionnaires.
resultsAmong 228 private practitioners, a median of 12 (IQR 4-28) patients with TB were seen per year. Of 10 ISTC standards evaluated, the median of standards adhered to was 4.0 (IQR 3.0-6.0). Chest physicians reported greater median ISTC adherence than other MD and MS practitioners (score 7.0 vs. 4.0, P<0.001), or MBBS practitioners (score 7.0 vs. 4.0, P<0.001). Only 52% of all practitioners sent >5% of patients with cough for TB testing, 83% used smear microscopy for diagnosis, 33% monitored treatment response, and 22% notified TB cases to authorities. Of 228 practitioners, 68 reported referring all patients with new pulmonary TB for treatment, while 160 listed 27 different regimens; 78% (125/160) prescribed a regimen classified as consistent with ISTC. Appropriate treatment practices differed significantly between chest physicians and other MD and MS practitioners (54% vs. 87%, P<0.001).
conclusionTB management practices in India's urban private sector are heterogeneous and often suboptimal. Private providers must be better engaged to improve diagnostic capacity and decrease TB transmission in the community.
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