A Cross-sectional Study on Knowledge, Attitude, and Practice Regarding Notification of Tuberculosis Patients by Private Practitioners of Urban Chennai, India

Abstract

Introduction: India accounts for one-fourth of global incidence of Tuberculosis (TB) with 2.79 million estimated cases annually. To improve and intensify case finding, the Government of India declared TB a notifiable disease in May 2012. It is now mandatory that all public and private health providers notify TB cases to the designated public health authorities. To facilitate notification, the central government has created a web-based, case-based notification system called NIKSHAY. Notification also provides support to the private sector in adherence to standards of TB care which helps in the monitoring of the patients, contact screening and adherence to the treatment. Aim: To assess the knowledge, opinion and barriers regarding TB notification and its processes amongst private practitioners offering TB services. Materials and Methods: This was a cross-sectional study with both analytical and descriptive components which was conducted on the private practitioners of urban Chennai for a period of three months from April 2021 to June 2021. Study was done on a convenient sample of 150 private practitioners in Urban Chennai. Any registered medical practitioner with a bachelor degree in medicine (MBBS) with private practice in Urban Chennai with a minimum of 1 year practice was included in the study. The knowledge, attitude and practice of notification of TB among private practitioners and other proportions were summarised into percentages and 95% confidence intervals were calculated. The categorical data was analysed by Chi-square (χ2) test. Strength of associations was assessed through odds ratio and 95% confidence intervals. Tha analysis of the data was done using Statistical Package for Social Sciences (SPSS) version 28.0.1.1. Results: Amongst the total sample of 150 study participants, 90% had said that TB notification was mandatory, of whom 80% said that they had prior sensitisation on the notification procedures. Only 46% were aware of the honorarium given after notification. Attitude of the study participants towards notification though 100% of the study participants agreed that TB notification was necessary, while 56.7% said that government should do more towards the sensitisation of the notification procedures. Only 5.3% of the study participants had initiated treatment on their own and 4% had started treatment based on clinical suspicion Nikshay registration was more among those whose duration of practice was more than or equal to 5 years (p=0.03), those who had prior sensitisation on TB notification procedures (p<0.001), those who had TB patients in their Outpatient Department (OPD) (p<0.001), and among those who were aware of the honorarium given for notification (p<0.001). Conclusion: Nikshay registration was significantly more among those who had prior sensitisation and those who were aware about the honorarium that they will receive after notifying. This shows that simple awareness creation can significantly increase the Nikshay registration thereby increasing the TB notification.

Keywords

• awareness
• contact tracing
• disease notification
• sensitisation
• treatment