Evaluation of the Directly Observed Treatment Short Course Program for Tuberculosis in Health Care Centers of Karachi: A Cross Sectional Study Highlighting the Problems Encountered

Objective: To assess and highlight the areas in which problems are encountered by the health care providers during delivery of DOTS therapy and hence are halting the success of DOTS and propagating the disease. Material & Methods: This was a cross sectional study with convenient sampling conducted between April 2016 to Sept 2016 at Primary Health Care centers in Karachi. A total of 100 Health care providers were part of this study. Out of these 100 health care workers, 25 were excluded from the study due to the incomplete filling of the questionnaire. A questionnaire was filled by the workers in which Demographic, clinical and treatment outcome factors and social determinants of health were recorded for each patient. Doctors, Nurses and Health Workers working as part time at Primary Health Care centers of Karachi with experience of more than 06 months were included. Ethical considerations were followed and names of participants and care centers were kept confidential. The data was analyzed through SPSS version 17.0 Results: Among the 75 respondents male to female ratio was 1:1. Around 36 (48%) were doctors, 18 (24%) were nurses, 21 (28%) were lady health workers. Their working experience was less than 1 year, 1 to 5 years, 6 to 10 years and more than 10 years in 17 (22.7%), 32 (42.7%), 13 (17.3 %) and 13 (17.3%) respectively. The compliance of the patients was below average, average and good in 46(61.3%), 22(29.3%), 7(9.3%) respectively. The overall TB DOT program was rated as Fair in 34(45%), good in 33(44%) and very good in 8(11%) Conclusion: The major areas of constrain highlighted are patient compliance to treatment, access to health facilities, education about TB and its treatment and problems faced during field work and reporting. However, refining these parameters will lead to paramount implementation of DOTS therapy and thus, can improve many folds and disease can drop reciprocally. Keywords: Evaluation; Directly observed treatment short course program; Tuberculosi