are children with tuberculosis in pakistan managed according to national programme policy guidelines a study from 3 districts in punjab在巴基斯坦儿童结核病管理国家课程政策的指导方针的一项研究显示3旁遮普地区.pdfVIP

Safdar et al. BMC Research Notes 2010, 3:324 /1756-0500/3/324 SHORT REPORT Open Access Are children with tuberculosis in Pakistan managed according to National programme policy guidelines? A study from 3 districts in Punjab 1,2* 2,4 3 4 Nauman Safdar , Sven Gudmund Hinderaker , Noor Ahmed Baloch , Donald A Enarson , 1 2 Muhammad Amir Khan , Odd Morkve Abstract Background: The adherence to policies of National TB Control Programme (NTP) to manage a case of tuberculosis (TB) is a fundamental step to have a successful programme in any country. Childhood TB services faces an unmet challenge of case management due to difficulty with diagnosis and relatively new policies. For control of childhood TB in Pakistan, NTP developed and piloted its guidelines in 2006-2007. The objective of this study was to compare the documented case management practices of pediatricians and its impact on the outcome before and after introducing NTP policy guidelines. Findings: An audit of case management practices of a historical cohort study was done in children below 15 years who were put on anti-tuberculosis treatment at all nine public hospitals in three districts in province of Punjab. The study period was two years pre-intervention (2004-05) and two years post-intervention (2006-07) after implementation of new NTP policy guidelines for childhood TB. There were 920 childhood TB cases registered during four years, 189 in pre-intervention period and 731 in post-intervention period. The practices changed significantly in post-intervention period for use of tuberculin skin test (63% of pulmonary cases, 19% of extrapulmonary cases and 67% for site unknown), and for the use of chest x-ray