TITLE:
Knowledge and Practice of Private Medical Practitioners regarding Diagnosis and Treatment of Paediatric Tuberculosis in Mogadishu
AUTHORS:
Abdihalim Mohamoud, Florence Murila, Ruth Nduati
KEYWORDS:
Paediatric TB, Diagnosis of TB in Children
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.7 No.2,
June
20,
2017
ABSTRACT: Background: Somalia has been at civil war for the last two decades and the public health system has virtually collapsed. The majority of the community seeks care from the private health sector. Objectives: To assess the knowledge and practice of private medical practitioners concerning Paediatric Tuberculosis (TB) diagnosis and treatment in Mogadishu and their level of adherence to the National or International guidelines using a cross-sectional study design. Methods: A cascade approach was used to identify private medical practitioners who had experience with treating paediatric TB. A standard tool was used to collect information on their knowledge of diagnosis and treatment among those who consented to participate in the study. In addition, prescriptions were retrieved from pharmacies in Mogadishu to enable independent verification of prescription practice and adherence to National or International guidelines. Results: There were 39 study participants, 31 medical doctors and 8 clinical officers. The most common symptoms used by clinicians to diagnose TB among children were fever for more than 2 weeks (87.19%), cough for more than 2 weeks (89.74%) and loss of weight (92.31%). A few, 5 (12.82%), identified history of TB contact as a suspicion of paediatric TB. More than half of the practitioners, 21 (53.85%), relied on chest x-ray and erythrocyte sedimentation rate for the diagnosis of TB in children. The majority (74%) of the clinicians knew the correct treatment for pulmonary TB in children. Further to this 60% and 79.5% respectively of the clinicians did not know the appropriate treatment regimens extra-pulmonary TB and TB/HIV co-infection. The lack of knowledge was confirmed by review of the prescriptions. Of the 48 prescriptions collected, only one prescription was correctly prescribed according to the weight of the child and even more worrying only 18 (39%) of the anti-TB drugs prescribed were Fixed Dose Combinations (FDC) approved by the WHO. Conclusion: Private medical practitioners in Mogadishu have significant gaps in their knowledge and practice with regard to the management of paediatric TB.