Tuberculosis Notification by Private Sector’ Physicians in Tehran

Abstract

Background: A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians.

Methods: A population‑based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors’ physicians has been chosen by the stratified
random sampling method. Appropriate descriptive analysis was used to describe the study’s participants. Logistic regression was used for bivariable and multivariable analysis.

Results: The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62–5, P < 0.01). Workplace and access to relevant resources are associated with TB notification (P < 0.05).

Conclusions: In poor resource settings with a high burden of TB, the public health administration can promote notification activities in the private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful.

Keywords: Mandatory reporting, private practice, public health