1.5 million Pakistanis infected with tuberculosis
By, The News, October 3, 2007
In a country with a population of 164,741,924 it is astounding to note that about 1.5 million people are currently affected by Tuberculosis (TB) .The worst part of the whole situation is that the number is constantly increasing due to the lack of adequate precautionary measures in, a study reveals this week. This is mainly arising out of the supposed in-sufficient medical education of doctors, the study adds.
“The core obstacle to effective TB control in Pakistan is inadequate medical education,” according to the study conducted by Aga Khan University Hospital (AKUH) in which 460 medical interns were surveyed.
The study was conducted by employing researchers at five teaching hospitals of the city (Aga Khan Hospital, Liaquat National Hospital, Jinnah Post-Graduate Medical Centre, Ayub Medical College and Lady Reading Hospital). The researchers assessed the knowledge and practices of recently graduated medical interns (house officers) about TB. These hospitals were selected because of the ‘convenience and accessibility’ they provided for the researchers.
The report highlighted what it called poor awareness of and low compliance to the World Health Organisation (Who)/National Tuberculosis Programme (NTP) guidelines among interns. The study conducted by Dr Javaid Khan, Head of the Pulmonary and Critical Care Section of AKUH suggests that for effective control of TB, immediate actions to improve undergraduate and continuing medical education are essential, with special emphasis on standard national guidelines.
TB remains a major health concern globally. Each year an estimated 8.7 million cases occur worldwide with 1.7 million deaths. At this pace more than 40 million people are expected to die of TB over the next 25 years. The vast majority (90%) of TB deaths occur in developing countries. Early detection and optimal treatment are the most important measures for disease control, the report said.
WHO has declared TB to be a global emergency and has published guidelines for its control in developing countries. Factors like relatively poor knowledge and non-compliance with guidelines among practicing physicians in Paksitan, have been noted with concern.
Erroneous decisions concerning the choice of treatment regimens and lack of means for the delivery of treatment will lead to the increasing occurrence of multi-drug resisting strains, which will ultimately prove fatal for an increasing number of TB patients, the researcher said.
The report pointed out that there are around 50 medical schools (25 in the public sector and 25 in the private sector) in the country with 5,000 medical graduates each year. These new medical graduates are required to complete 12 months of internship (house job) to obtain practical work experience.
Awareness of National Health Programmes and management of common diseases is considered crucial to the successful integration of graduates into high quality practice in any community.
While highlighting the perceived “serious deficiencies” in the knowledge and practice of newly graduated physicians with respect to TB, the study suggests a systematic review of education of medical students and of practitioners to improve the current poor quality of clinical practice, and to avoid harmful consequences of poor treatment outcome and development of drug resistant TB.
The identification of infectious (smear positive) cases of active TB is of paramount importance in the control of TB. All guidelines recommend three consecutive sputum-smear examinations as the investigation of choice for the diagnosis of active TB. In this study, however, only a minority of interns used sputum smears for diagnosis, whereas the majority relied on other diagnostic procedures. Similar practices were seen among general physicians who used sputum smear microscopy in only 38 per cent of diagnoses for pulmonary TB.
“This vicious cycle of poor sputum smear microscopy facilities, poor utilisation of smear examination by established practitioners and poor education of graduating doctors is leading to poor TB control,” the report said, adding that this has to be tackled as a matter of priority.
The study makes several suggestions like giving importance to TB in the existing curriculum of medical schools on the pattern of diabetes and heart failure and its inclusion in examinations at various levels so that the students give importance to this subject of tremendous public health value.
Source: http://www.thenews.com.pk/print1.asp?id=74470
In a country with a population of 164,741,924 it is astounding to note that about 1.5 million people are currently affected by Tuberculosis (TB) .The worst part of the whole situation is that the number is constantly increasing due to the lack of adequate precautionary measures in, a study reveals this week. This is mainly arising out of the supposed in-sufficient medical education of doctors, the study adds.
“The core obstacle to effective TB control in Pakistan is inadequate medical education,” according to the study conducted by Aga Khan University Hospital (AKUH) in which 460 medical interns were surveyed.
The study was conducted by employing researchers at five teaching hospitals of the city (Aga Khan Hospital, Liaquat National Hospital, Jinnah Post-Graduate Medical Centre, Ayub Medical College and Lady Reading Hospital). The researchers assessed the knowledge and practices of recently graduated medical interns (house officers) about TB. These hospitals were selected because of the ‘convenience and accessibility’ they provided for the researchers.
The report highlighted what it called poor awareness of and low compliance to the World Health Organisation (Who)/National Tuberculosis Programme (NTP) guidelines among interns. The study conducted by Dr Javaid Khan, Head of the Pulmonary and Critical Care Section of AKUH suggests that for effective control of TB, immediate actions to improve undergraduate and continuing medical education are essential, with special emphasis on standard national guidelines.
TB remains a major health concern globally. Each year an estimated 8.7 million cases occur worldwide with 1.7 million deaths. At this pace more than 40 million people are expected to die of TB over the next 25 years. The vast majority (90%) of TB deaths occur in developing countries. Early detection and optimal treatment are the most important measures for disease control, the report said.
WHO has declared TB to be a global emergency and has published guidelines for its control in developing countries. Factors like relatively poor knowledge and non-compliance with guidelines among practicing physicians in Paksitan, have been noted with concern.
Erroneous decisions concerning the choice of treatment regimens and lack of means for the delivery of treatment will lead to the increasing occurrence of multi-drug resisting strains, which will ultimately prove fatal for an increasing number of TB patients, the researcher said.
The report pointed out that there are around 50 medical schools (25 in the public sector and 25 in the private sector) in the country with 5,000 medical graduates each year. These new medical graduates are required to complete 12 months of internship (house job) to obtain practical work experience.
Awareness of National Health Programmes and management of common diseases is considered crucial to the successful integration of graduates into high quality practice in any community.
While highlighting the perceived “serious deficiencies” in the knowledge and practice of newly graduated physicians with respect to TB, the study suggests a systematic review of education of medical students and of practitioners to improve the current poor quality of clinical practice, and to avoid harmful consequences of poor treatment outcome and development of drug resistant TB.
The identification of infectious (smear positive) cases of active TB is of paramount importance in the control of TB. All guidelines recommend three consecutive sputum-smear examinations as the investigation of choice for the diagnosis of active TB. In this study, however, only a minority of interns used sputum smears for diagnosis, whereas the majority relied on other diagnostic procedures. Similar practices were seen among general physicians who used sputum smear microscopy in only 38 per cent of diagnoses for pulmonary TB.
“This vicious cycle of poor sputum smear microscopy facilities, poor utilisation of smear examination by established practitioners and poor education of graduating doctors is leading to poor TB control,” the report said, adding that this has to be tackled as a matter of priority.
The study makes several suggestions like giving importance to TB in the existing curriculum of medical schools on the pattern of diabetes and heart failure and its inclusion in examinations at various levels so that the students give importance to this subject of tremendous public health value.
Source: http://www.thenews.com.pk/print1.asp?id=74470
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