scholarly journals How do private practitioners in Pakistan manage children suspected having tuberculosis?

2020 ◽  
Author(s):  
Aashifa Yaqoob ◽  
Sven Hinderaker ◽  
Razia Fatima ◽  
Hina Najmi ◽  
Anwar Haq
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Failure To Thrive ◽  
Cross Sectional Study ◽  
Private Provider ◽  
Private Health Care ◽  
Health Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Private Providers

Abstract Background:Private providers provide a large portion of health care in Pakistan, including tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision and support. Diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods:This cross-sectional study was based on a national survey that measured under-reporting of children with TB in 12 selected districts in Pakistan from Apr-Jun, 2016. We explored the practices of private health care providers, like general practitioners, pediatricians, pulmonologists and chest specialists, involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB.Results:Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG scar was more common in female children. Private providers relied on chest X-ray in 46.1%, but tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP).Conclusion:This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but cases identified in investigations were often not notified to the NTP. This problem needs to be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.

scholarly journals How do private practitioners in Pakistan manage children suspected having tuberculosis? A cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aashifa Yaqoob ◽  
Sven Gudmund Hinderaker ◽  
Razia Fatima ◽  
Hina Najmi ◽  
Anwar-ul-Haq
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Failure To Thrive ◽  
Cross Sectional Study ◽  
Private Provider ◽  
Private Health Care ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Private Providers

Abstract Background In Pakistan, private providers provide a large portion of health care, including for tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision, and support. However, diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods We used a cross-sectional study, which was based on a national survey measuring under-reporting of children with TB in 12 selected districts in Pakistan from April–June, 2016. We explored the practices of the private health care providers, including the health care workers i.e. general practitioners, pediatricians, pulmonologists and chest specialists, who were involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB. Results Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG (Bacillus Calmette–Guérin) scar was more common in female children. Private providers relied on chest X-ray in 46.1%, while tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP). Conclusion This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but the cases identified in these investigations were often not notified to the NTP. This problem could be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.

scholarly journals How do private practitioners in Pakistan manage children suspected having tuberculosis?

2020 ◽  
Author(s):  
Aashifa Yaqoob ◽  
Sven Hinderaker ◽  
Razia Fatima ◽  
Hina Najmi ◽  
Anwar Haq
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Failure To Thrive ◽  
Cross Sectional Study ◽  
Private Health Care ◽  
Health Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Private Providers ◽  
Childhood Tb

Abstract Background: Private providers provide a large portion of health care in Pakistan, including tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision and support. It is difficult to confirm the diagnosis of TB in children. We aimed to assess the private health care provider investigation practices and management of childhood TB. Methods: This cross sectional study was based on a national survey that measured under-reporting of children with TB in 12 selected districts in Pakistan from Apr-Jun, 2016. We explored the practices of private health care providers involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB, like general practitioners, pediatricians, pulmonologists and chest specialists. Results: Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under the age of 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Out of all diagnosed TB cases, only 187(3.6%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. For further diagnostic tests, private providers relied on chest X-ray in 41.7% of 0-4 years and 48.2% of 5-14 years. Utilization of Tuberculin skin test and Gene-Xpert MTB/RIF testing was very low. Bacteriological confirmation was present in 9.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre(NTP). Conclusion: This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but cases identified in investigations were often not notified to the NTP. This problem needs to be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.

scholarly journals How do private practitioners in Pakistan manage children suspected having tuberculosis? A cross sectional study

2020 ◽  
Author(s):  
Aashifa Yaqoob ◽  
Sven Hinderaker ◽  
Razia Fatima ◽  
Hina Najmi ◽  
Anwar Haq
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Failure To Thrive ◽  
Cross Sectional Study ◽  
Private Provider ◽  
Private Health Care ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Private Providers

Abstract Background: In Pakistan, private providers provide a large portion of health care, including for tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision, and support. However, diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods:We used a cross-sectional study, which was based on a national survey measuring under-reporting of children with TB in 12 selected districts in Pakistan from April-June, 2016. We explored the practices of the private health care providers, including the health care workers i.e. general practitioners, pediatricians, pulmonologists and chest specialists, who were involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB. Results:Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG (Bacillus Calmette–Guérin) scar was more common in female children. Private providers relied on chest X-ray in 46.1%, while tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP). Conclusion:This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but the cases identified in these investigations were often not notified to the NTP. This problem could be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.

scholarly journals How do private practitioners in Pakistan manage children suspected having tuberculosis? A cross sectional study

2020 ◽  
Author(s):  
Aashifa Yaqoob ◽  
Sven Hinderaker ◽  
Razia Fatima ◽  
Hina Najmi ◽  
Anwar Haq
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Failure To Thrive ◽  
Cross Sectional Study ◽  
Private Provider ◽  
Private Health Care ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Private Providers

Abstract Background:In Pakistan, private providers provide a large portion of health care, including for tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision, and support. However, diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods:We used a cross-sectional study, which was based on a national survey measuring under-reporting of children with TB in 12 selected districts in Pakistan from April-June, 2016. We explored the practices of the private health care providers, including the health care workers i.e. general practitioners, pediatricians, pulmonologists and chest specialists, who were involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB.Results:Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG scar was more common in female children. Private providers relied on chest X-ray in 46.1%, while tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP).Conclusion:This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but the cases identified in these investigations were often not notified to the NTP. This problem could be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.

scholarly journals Exclusive breastfeeding knowledge and practices among health care workers in northern Tanzania.

2020 ◽  
Author(s):  
Melina Mgongo ◽  
Bertha Mlay ◽  
Damian Jeremia Damian ◽  
Caroline Amour ◽  
Beatrice John Leyaro ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Child Survival ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Northern Tanzania

Abstract Background Exclusive breastfeeding (EBF) practice is one of the interventions improving child survival. Health workers have been shown to be vital in influencing EBF practices. Objectives To assess the level of knowledge and supportive practices on EBF among healthcare workers Kilimanjaro region, northern Tanzania. Methods A cross sectional study was conducted between April - June 2011 health care providers working in 36 randomly selected health facilities of Hai and Siha districts. A questionnaire was used to obtain information. Observation of health worker-client interaction was conducted using a check list. Results A total of 250 health workers participated in this study. The majority (80%) had adequate knowledge of EBF. However, 36% of providers believed light porridge should be introduced after 4 months and 43% believed infants will feel thirsty on breast- milk alone. Only 7% of providers answered correctly on skills of support, positioning and attachment. Fifty percent of the facilities with labour/maternity wards gave breastfeeding lessons to post delivery women. The majority (90%) gave theoretical information, without practical demonstration with positioning and/or attachment of the baby to the breast. Conclusion Providers had adequate theoretical knowledge of EBF but lacked important skills to support women in breastfeeding practices. Few labor/maternity facilities used the opportunity to educate women on EBF. Pre- and in-service health providers’ training on breastfeeding should target improved practical skills.

scholarly journals Survey of knowledge for diagnosing and managing prediabetes in Latin-America: cross-sectional study

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Jennifer Garay ◽  
Paul A. Camacho ◽  
Jose Lopez-Lopez ◽  
Juliana Alvernia ◽  
Marcela Garcia ◽  
...  
Keyword(s):  
Health Care ◽  
Latin America ◽  
Risk Factor ◽  
Latin American ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background Prediabetes has been proposed as a risk factor for the development of type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). Despite the clinical importance of prediabetes, little is known about the level of knowledge, beliefs and barriers to screening and treating prediabetes amongst care health providers in Latin America. The aim of the present survey was to evaluate the knowledge and beliefs about prediabetes amongst in Latin American health care providers. Methodology In a cross-sectional study, we adapted the written survey designed by the Johns Hopkins University group, and applied it to health care providers across Latin America during three meetings, in 2017, and with physicians from primary care centers in Bucaramanga, Colombia convened in 2017. The survey consisted of questions under four headings, diabetes screening, management of prediabetes, pharmacological treatment—metformin use, and demographic information. We perform a descriptive analysis to determine the differences in responses between different medical specialties. Results The majority of the care providers that answered the survey were Colombian physicians, 54.5% of respondents had 10 years or more since completing their training and more women responded. Only 9.5% identified the 12 prediabetes risk factors described in the literature. The most common risk factor identified was a family history of diabetes, followed by overweight, a sedentary lifestyle and dyslipidemia, while ethnicity was the risk factor least commonly. 47.1% answered that laboratory tests to detect prediabetes are fasting glucose and HbA1C, 82.5% correctly identified fasting plasma glucose as the best test, 35.9% correctly responded that to the recommended weight loss goal is 5 to 7% and 49.1% that 150 min is considered the minimum level of physical activity per week. 78% agreed that the identification and treatment of prediabetes is important. 56% believed that patients with prediabetes progress more rapidly to diabetes and 40.6% considered that metformin could reduce the risk of diabetes in patients already diagnosed with prediabetes. Conclusion These results demonstrate that there are important gaps in the knowledge of the diagnosis, clinical implications and management of prediabetes amongst Latin America health providers.

scholarly journals Exclusive breastfeeding knowledge and practices among health care workers in Northern Tanzania.

2020 ◽  
Author(s):  
Melina Mgongo ◽  
Bertha Mlay ◽  
Damian Jeremia Damian ◽  
Caroline Amour ◽  
Beatrice John Leyaro ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Child Survival ◽  
Cross Sectional Study ◽  
Health Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Northern Tanzania

Abstract Background: Exclusive breastfeeding (EBF) practice is one of the interventions improving child survival. Health workers have been shown to be vital in influencing EBF practices.Objectives: To assess the level of knowledge and supportive practices on EBF among healthcare workers Kilimanjaro region, northern Tanzania.Methods: A cross sectional study was conducted between April - June 2011 health care providers working in 36 randomly selected health facilities of Hai and Siha districts. A questionnaire was used to obtain information. Observation of health worker-client interaction was conducted using a check list.Results: A total of 250 health workers participated in this study. The majority (80 %) had adequate knowledge of EBF. However, 36 % of providers believed light porridge should be introduced after 4 months and 43 % believed infants will feel thirsty on breast- milk alone. Only 7 % of providers answered correctly on skills of support, positioning and attachment. Fifty percent of the facilities with labour/maternity wards gave breastfeeding lessons to post delivery women. The majority (90 %) gave theoretical information, without practical demonstration with positioning and/or attachment of the baby to the breast.Conclusion: Providers had adequate theoretical knowledge of EBF but lacked important skills to support women in breastfeeding practices. Few labor/maternity facilities used the opportunity to educate women on EBF. Pre- and in-service health providers’ training on breastfeeding should target improved practical skills.

scholarly journals Assessing Knowledge on Clubfoot Among Parents Having Children with Clubfoot Deformity

2015 ◽  
Vol 14 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Zobaer Alam ◽  
Md Monoarul Haque ◽  
Md Rijwan Bhuiyan ◽  
Md Shahinoor Islam ◽  
Monirul Haque ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Public Health Problem ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Childhood Disability ◽  
Care Providers ◽  
Cross Sectional ◽  
Middle Income ◽  
Level Of Knowledge

Background: The burden of childhood disability as a public health problem in developing countries remains relatively unrecognized. One out of 750 children born in the world suffer from club foot among them 80% are in low and middle income countries. Most of these babies have limited access to receive effective treatment for their clubfoot due to lack o knowledge, awareness and some barriers. We actually don’t know the level of knowledge of parents who have child with clubfoot deformity. The purpose of this study was to assess the level of knowledge of parents who have children with clubfoot during clubfoot treatment. Materials and Methods: This cross sectional study was conducted among 102 parents who have children with clubfoot deformity during its treatment in a selected clinic. The samples were selected purposively from the clinics where clubfoot treatment was given and face to face interview was done by using semi-structured questionnaire. Results: The mean (±SD) age of the respondents were 24.7 (±6.0) years where 87.3% (n=89) respondents ware female and 59.8 %(n=61) respondent’s educational status ware up to primary level. About 44.1% respondents started treatment of their child within 6 months of birth and 33% within 6 to 12 months where 57% (n=58) respondents are referred by health care professional to this clinics. About 93.1% of parents (n=95) said that they knew nothing about clubfoot deformity before their child was diagnosed where 97% are aware after diagnosis of their child. About 93.1% respondents knew the best time for treatment initiation where 59.8% respondents know the correct follow up time of clubfoot management. In case of knowledge of parents’ roles in the treatment of clubfoot about 91.2%, parents have knowledge weekly visit for treatment and 86.3% know the plaster care where 52.9% (n=54) parents have lack of knowledge about how to use the brace Conclusion: There is need to improve the communication skills of clinicians/health care providers offering treatment to children with clubfoot at the Clinics. Need to share information with the parents about the condition. Finally, there is need to emphasize of educating parents about plaster care and how to use brace. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22882 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 42-46

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