Razia Chaudhry, Saeed Zaheer, Naheed Humayun Sheikh.
Awareness of dots regarding management of pulmonary tuberculosis, among resident doctors and final year medical students in tertiary level health care facility.
Biomedica Jan ;28(1):82-7.

Objective: To assess and compare the awareness level regarding management of pulmonary tuberculosis including DOTS among resident doctors of JHL and final year medical students of AIMC and to find weak areas regarding it which need interventions according to WHO recommendations, at tertiary care level hospitals. It is a cross sectional comparative, study carried out from May 2010 to Sept. 2010, of Jinnah Hospital Lahore. Material and Methods: In this study regarding awareness of DOTS strategy among doctors and medical students, doctors had designation as SRs 8, PGs 36, SHOs 56 and final year students were 110 (Total 210). A semi – structured questionnaire was filled by the trained medical students. Results: Regarding sputum microscopy for AFB as standard test for diagnosis of new case of pulmonary TB, 50% resident doctors and 51% students answered in favour of it, while 20% doctors and 12% students preferred x-ray chest as 1st choice and rest 15% preferred isolation by culture, mycodot and severity of symptoms (P = 0.04). Regarding the knowledge about time taken for growth of AFB on culture media 70% doctors and 61% students answered correctly (P = 0.2122), whereas 83.8% students and 89% residents knew what ‘DOTS’ stands for? Both 84% doctors and students gave multiple reasons in favour of “why DOTS” as it is cost effective, better patient’s compliance and stops MDR. Only 10% said that it is WHO’S recommended strategy (P = 0.002). Only 30% doctors follow the complete standard management regime as described by DOTS for different categories of patients with pulmonary tuberculosis while only 16% 5th year medical students were able to classify patients according to drug regimen and category. Sixty % doctors 34% SRs, 20% PGs and 6% house officers chose “sputum microscopy” as best tool to monitor the progress of case3 under treatment for pulm. TB. while 20% preferred chest X-ray for this purpose. Conclusion: There are multiple weak areas about knowledge and practices of doctors in tertiary care level hospitals about DOTS and its strategies for patients of pulmonary tuberculosis. Majority of the doctors were not awared that DOTS facility is available in JHL. Hence education of hospital doctors is important because private practitioners (pps) generally tend to follow the prescription written by doctors in the teaching hospitals.

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