Role of General practitioners in TB Control

By Dr MM Nowshad

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Directly Observed Treatment of Short course (DOTS)

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DOT means that a trained health care worker or other designated individual

(excluding a family member) provides the prescribed TB

drugs and watches the patient swallow every dose.

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Public sectorPrivate sector

• case detection • ensure complete cure

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General Practitioners identify the TB suspects and refer to the

District Chest Clinicfor investigation and treatment.

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AMHBH Kalmunai

BH AkkaraipattuDBH Pottuvil

PU Central CampCD Irakkamam

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GP fills the Sputum formand sends to Microscopy lab

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One form enough for all 2/3 sputum samples

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Send to DCC

patient who refuses to go to the District Chest Clinic even after thediagnosis of sputum smear positive

pulmonary TB was made.

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• propagates DOTS • Act as DOTS provider

Own patientsReferred patients

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All TB suspectsrefer to DCC

diagnosistreatment

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GP will inform the patients that the sputum microscopy is the primary and

mostreliable diagnostic tool of pulmonary

TB

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GP will inform the District Tuberculosis Control Officer with all the relevant

information of the patient necessary for registration at the District Chest

Clinic

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Registration of all diagnosed TB patients done only in

District Chest ClinicOnly one TB register

maintained for whole district

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patients diagnosed of TB-GP inform patients• follow up sputum examinations necessary

At 3month, 5th month and 6th month• importance of DOT

• To complete treatment

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• Train staff• Records

• Inform complications• Defaulters- DTCO

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1. DCC2. AMH

3. BH Kalmunai4. BH Akkaraipattu

5. DBH Pottuvil6. CD Ullai

7. Additional centers approved-CD Sennal Kramam, PU Central Camp,

DH Palamunai

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The referring GP would be informed of the result of investigation of the

referred patient and if diagnosed as Tuberculosis, the type and duration of

treatment.

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Regular drug supply free of charge

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provide the treatment card, requests forms for sputum microscopy

and the referral forms.

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Get back defaulters

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Follow up programevaluation

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• reliable diagnostic tool than X-ray • Simple to perform

• Easy to read • Quick results • Inexpensive

• Minimal infrastructure required to set up a microscopy centre

• High sensitivity and specificity for detecting infectious cases.

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Sustained political and financial commitment

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  Diagnosis by quality ensured sputum-smear

microscopy

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Standardized short-course anti-TB treatment given

under direct and supportive observation

(DOT)

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  A regular, uninterrupted supply of high quality

anti-TB drugs

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Monitoring and evaluation system, Standardized

recording and reporting

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Thank you

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