Survey of knowledge, attitudes and practices for tuberculosis among general practitioners in Delhi, India

SETTING: Random survey of knowledge, attitudes and practices (KAP) for tuberculosis among private practitioners (PPs) in Delhi, India, in 1995. OBJECTIVE: To investigate the KAP of private practitioners for tuberculosis in Delhi where the Revised National Tuberculosis Programme (RNTP) is being field tested. DESIGN: A pre-tested questionnaire survey was performed among 204 doctors attending updates/seminars on tuberculosis in various parts of Delhi. RESULTS: In a suspected case of tuberculosis, sputum examination was advised by only 12% of the PPs, while 89.5% would recommend chest X-ray. For treating tuberculosis 187 PPs were using 102 different regimens, and only 29.4% PPs were using the regimen recommended by the RNTP; 51.3% PPs were over-treating their patients. Only 23.5% of PPs requested sputum examination before the end of treatment, while 35.5% depended on X-ray clearance with clinical improvement. Only 19.5% of PPs emphasized the importance of regular treatment for their patients. CONCLUSION: Among PPs there is marked reliance on X-ray; sputum examination is being neglected for initial diagnosis, treatment monitoring and as a criterion for stopping treatment. The majority of PPs are not aware of, or are not prescribing, the treatment regimen recommended by the RNTP, and the majority of patients are being over-treated. There is a lack of emphasis on proper health education. PPs need more training, and more collaborative efforts are required between public health facilities and practising doctors for national control of tuberculosis.