Table 1. Socio-demographic profile and management practices for all forms of TB among private practitioners in Chennai, India (n = 228).
| Patients Diagnosed with TB in Past Year | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Characteristic | Total (n = 228) n(%) | ≤12 Patients (n = 110) n(%) | >12 Patients (n = 118) n(%) | Unadjusted PR (95% CI)† | P | Adjusted PR (95% CI)1 | P1 | Adjusted PR (95% CI)2 | P2 |
| Male | 160 (70) | 67 (61) | 93 (79) | 1.6 (1.1–2.3) | 0.01 | 1.2 (0.9–1.7) | 0.23 | 1.3 (0.9–1.8) | 0.21 |
| Education | |||||||||
| MBBS | 81 (35) | 53 (48) | 28 (24) | REF | REF | REF | |||
| MD (General internal medicine) | 11 (5) | 5 (4) | 6 (5) | 1.1 (0.6–1.8) | 0.84 | 1.3 (0.9–2.0) | 0.21 | 1.5 (0.8–2.6) | 0.19 |
| MD (Chest/Pulmonary specialty) | 39 (17) | 6 (6) | 33 (28) | 1.9 (1.5–2.4) | <0.001 | 1.9 (1.4–2.6) | <0.001 | 2.3 (1.5–3.5) | <0.001 |
| MD (Other specialty) | 86 (38) | 42 (38) | 45 (38) | 1.0 (0.8–1.3) | 0.99 | 1.4 (0.9–2.1) | 0.10 | 1.6 (1.0–2.5) | 0.04 |
| MS | 11 (5) | 4 (4) | 6 (5) | 1.2 (0.7–2.1) | 0.60 | 1.6 (0.8–3.2) | 0.19 | 1.7 (0.8–3.7) | 0.17 |
| Years practicing, median [IQR] | 20 [15–30] | 20 [12–30] | 25 [15–30] | 1.0 (1.0–1.0) | 0.03 | 1.0 (1.0–1.0) | <0.001 | 1.0 (1.0–1.0) | 0.01 |
| Practitioner specialty | |||||||||
| General medicine | 155 (68) | 85 (77) | 70 (59) | REF | REF | REF | |||
| Chest/Pulmonary specialist | 37 (16) | 4 (4) | 33 (28) | 1.9 (1.5–2.4) | <0.001 | Omitted | 1.7 (1.3–2.1) | <0.001 | |
| Other* | 36 (16) | 21 (19) | 15 (13) | 0.8 (0.5–1.2) | 0.21 | 0.8 (0.5–1.2) | 0.30 | 0.8 (0.5–1.2) | 0.22 |
| Type of facility | |||||||||
| Government with private practice in evening | 22 (10) | 13 (12) | 9 (8) | REF | REF | ||||
| Private standalone clinic or polyclinic | 129 (56) | 76 (69) | 53 (45) | 0.6 (0.5–0.8) | <0.001 | -- | |||
| Private hospital or nursing home | 77 (34) | 21 (19) | 56 (47) | 1.8 (1.4–2.3) | <0.001 | -- | |||
| Action for pulmonary TB diagnosis | |||||||||
| Refer to RNTCP or PPM DOTS center | 97 (42) | 55 (50) | 42 (36) | REF | REF | ||||
| Treatment in private sector | 131 (58) | 55 (50) | 76 (64) | 1.3 (1.0–1.8) | 0.05 | 1.1 (0.8–1.4) | 0.66 | ||
| Knowledge of TB notification requirement** | 214 (94) | 99 (90) | 115 (98) | 2.5 (0.8–8.0) | 0.12 | 1.7 (0.7–4.5) | 0.26 | ||
| Notification training | 118 (52) | 39 (36) | 79 (67) | 1.9 (1.5–2.4) | <0.001 | 1.5 (1.2–2.0) | <0.01 | ||
| Notified RNCTP of any TB patients | 49 (22) | 20 (18) | 29 (25) | 1.2 (0.9–1.6) | 0.25 | 1.0 (0.7–1.3) | 0.84 | ||
| Knowledge of serological antibody test ban | 126 (55) | 48 (44) | 78 (66) | 1.6 (1.1–2.3) | 0.02 | 1.2 (0.9–1.6) | 0.21 | ||
| Awareness of PPM schemes via RNTCP | 81 (35) | 37 (34) | 44 (37) | 1.1 (0.8–1.5) | 0.66 | 0.9 (0.7–1.2) | 0.40 | ||
| Source of information on TB** | |||||||||
| No sources/not PP's specialty | 39 (17) | 28 (16) | 11 (9) | 0.5 (0.3–0.9) | 0.02 | 0.4 (0.2–0.8) | <0.01 | ||
| Journals, books, newspaper, newsletters | 82 (36) | 36 (33) | 46 (39) | 1.1 (0.9–1.4) | 0.28 | 0.8 (0.6–1.0) | 0.03 | ||
| Internet | 71 (31) | 33 (30) | 38 (32) | 1.1 (0.8–1.3) | 0.66 | 0.9 (0.7–1.2) | 0.45 | ||
| CME or workshop | 99 (43) | 45 (41) | 54 (46) | 1.1 (0.8–1.5) | 0.55 | 0.7 (0.5–1.0) | 0.03 | ||
| Medical representative or colleague | 25 (11) | 15 (14) | 10 (9) | 0.8 (0.4–1.3) | 0.33 | 0.7 (0.4–1.2) | 0.24 | ||
MD, Medical doctor degree; MS, Master of surgery degree; MBBS, Bachelor of medicine and bachelor of surgery undergraduate degrees; RNTCP, Revised National TB Control Program; PPM DOTS, Public-Private Mix directly observed therapy short course.
*Other MD and MS practitioner specialties included Obstetrics and gynecology (n = 15), Pediatrician (n = 5), Surgeon (General/Orthopedic/Ophthalmologic) (n = 4), Diabetes Specialist (n = 6), Ear nose and throat (n = 2), Oncologist (n = 1), and Radiologist (n = 1).
**Categories are not mutually exclusive.
†Unadjusted prevalence ratio comparing practitioners with annual TB patient volumes of at least 12 patients versus greater than 12 patients with TB per year.
1Prevalence ratio adjusted for all variables with data in this column. Adjusted PR for pulmonary specialist omitted due to overlap with education. Variance inflation factors were below 3.0 for all covariates included in the model.
2Prevalence ratio adjusted for sex, education, years practicing, and specialty. Variance inflation factors were below 3.0 for all covariates included in the model.