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    193980

    Tuberculosis in Pakistan: are we losing the battle? [editorial]

    Khan JA; Malik A

    Journal of the Pakistan Medical Association. 2003 Aug; 53(8):[2] p..

    How many private practitioners (PPs) listening to usual complaints of 'fever, cough and weakness for over two weeks' consider a diagnosis of active tuberculosis? In Pakistan, where TB is endemic and has assumed large proportions, the diagnosis would be considered and correctly treated by only a small percentage of PPs. A study recently conducted by the authors in Karachi showed that only 66% PPs ordered sputum microscopy as the preferred method for diagnosing TB. Only 50% thought themselves as capable enough to treat patients with pulmonary TB. Only 21% doctors prescribed a correct regimen in accordance with NTP or WHO guidelines. In such circumstances, if the PPs are treating 80% of patients presenting to them with tuberculosis1, one can imagine how worse the situation can get. Despite the fact that World Health Organization (WHO), in its effort to control TB, declared it a global emergency in 1993, TB still continues to account for the largest burden of mortality by any infectious agent worldwide. It is the second leading cause of adult death in impoverished communities of Karachi. Globally, Pakistan ranks 8th in terms of estimated number of cases by WHO, with an incidence of 175/100,000 persons. Pakistan alone accounts for 44% of total TB burden in the Eastern Mediterranean Region of the WHO comprising 23 countries. (excerpt)
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