At least three research
studies published in the past four months have found that a large percentage of
doctors in the private sector delay diagnosis, fail to not notify the
government, and offer substandard treatment for tuberculosis.
On International Day for Tuberculosis (March 24), public health experts accused the medical community of letting the preventable, curable disease to become Chennai's biggest communicable killer. Most doctors were not up to date with national standards of diagnosis, management and treatment of the disease.
More than half the patients visit a private physician as the first point of reference. "We found huge delays in diagnosis. Often standard procedures weren't followed for diagnosis or prescriptions," said Dr Nalini Krishnan, who heads REACH, an NGO that works for advocacy and education in tuberculosis.
A study she authored was published in the International Journal of Tuberculosis and Lung Diseases this week. A cross-sectional survey of 289 patients diagnosed with TB in the private sector showed diagnosis was made after nearly three visits to the doctor in two months. Another study published in the same journal found that the management practices in Chennai were sub-optimal.
Nearly half the number of physicians did not send patients with a cough for TB test, and a majority of them (83%) used less accurate tests such as smear microscopy instead of the standard sputum test. Tuberculosis is an airborne infectious disease. India has more than one quarter of the world's nine million tuberculosis cases. If untreated, a person with TB can infect 10 to 15 others in a year. The Union health ministry has made it mandatory for doctors to notify TB cases to the government. But another survey of 190 private practitioners in the city by the National Institute for Research in Tuberculosis showed that only 33% of them reported that their patients had tuberculosis.
Nearly 80% of the doctors said they referred cases to government hospitals. "But there is no way to check if these patients got treatment. Some of them could have dropped out and they could spread the infection to others," said Dr Beena Elizabeth Thomas, one of the authors of the study.
More than 50% doctors said they did not report the disease for paucity of time. Another quarter said they feared it would breach confidentiality. However, public health experts said when it comes to public health issues, community rights should override individual rights. It is important to prevent outbreaks by keeping those infected under quarantine until they cross the infectious stage, they said.
Indian Medical Association said it is aware of physicians delaying diagnosis and not notifying diseases. The association has decided to educate doctors on the national guidelines provided by the revised national tuberculosis control programme. It will also send updates through mails and messages through the year, said IMA Tamil Nadu chapter president Dr TN Ravishankar. "We are telling doctors to notify TB as soon as it is diagnosed. They should send patients to government hospital if he/she can't afford treatment. It is the doctor's responsibility to follow up with the patient till tests show negative for TB," he said.
On International Day for Tuberculosis (March 24), public health experts accused the medical community of letting the preventable, curable disease to become Chennai's biggest communicable killer. Most doctors were not up to date with national standards of diagnosis, management and treatment of the disease.
More than half the patients visit a private physician as the first point of reference. "We found huge delays in diagnosis. Often standard procedures weren't followed for diagnosis or prescriptions," said Dr Nalini Krishnan, who heads REACH, an NGO that works for advocacy and education in tuberculosis.
A study she authored was published in the International Journal of Tuberculosis and Lung Diseases this week. A cross-sectional survey of 289 patients diagnosed with TB in the private sector showed diagnosis was made after nearly three visits to the doctor in two months. Another study published in the same journal found that the management practices in Chennai were sub-optimal.
Nearly half the number of physicians did not send patients with a cough for TB test, and a majority of them (83%) used less accurate tests such as smear microscopy instead of the standard sputum test. Tuberculosis is an airborne infectious disease. India has more than one quarter of the world's nine million tuberculosis cases. If untreated, a person with TB can infect 10 to 15 others in a year. The Union health ministry has made it mandatory for doctors to notify TB cases to the government. But another survey of 190 private practitioners in the city by the National Institute for Research in Tuberculosis showed that only 33% of them reported that their patients had tuberculosis.
Nearly 80% of the doctors said they referred cases to government hospitals. "But there is no way to check if these patients got treatment. Some of them could have dropped out and they could spread the infection to others," said Dr Beena Elizabeth Thomas, one of the authors of the study.
More than 50% doctors said they did not report the disease for paucity of time. Another quarter said they feared it would breach confidentiality. However, public health experts said when it comes to public health issues, community rights should override individual rights. It is important to prevent outbreaks by keeping those infected under quarantine until they cross the infectious stage, they said.
Indian Medical Association said it is aware of physicians delaying diagnosis and not notifying diseases. The association has decided to educate doctors on the national guidelines provided by the revised national tuberculosis control programme. It will also send updates through mails and messages through the year, said IMA Tamil Nadu chapter president Dr TN Ravishankar. "We are telling doctors to notify TB as soon as it is diagnosed. They should send patients to government hospital if he/she can't afford treatment. It is the doctor's responsibility to follow up with the patient till tests show negative for TB," he said.