Informal allopathic provider knowledge and practice regarding control and prevention of TB in rural Bangladesh

Abstract

Background: BRAC (formerly Bangladesh Rural Advancement Committee), in collaboration with the National Tuberculosis Control Programme, provides one full-day training on TB to make informal allopathic providers knowledgeable for managing TB in rural Bangladesh. This study explored the knowledge and practices of the providers receiving the above training in the control and prevention of TB.

Methods: The study was conducted in 30 subdistricts, with 30 trained and 30 untrained providers randomly selected from each subdistrict. Approximately 3% (49/1800) did not provide complete information. Pre-tested structured and semi-structured questionnaires were used.

Results: TB was commonly perceived as a disease of only males (66.1%, 1157/1751). Only one-quarter knew about the bacterial cause of TB. Very few providers (2.1%, 36) had adequate knowledge regarding prevention of TB. They also lacked knowledge about TB treatment duration (71.6%, 1253), the meaning of DOTS (directly observed treatment, short course) (26.0%, 455) and multidrug resistance (20.6%, 360). Antibiotics (79.7%, 1396) and cough syrup (75.0%, 1313) were commonly prescribed by providers despite symptoms suggestive of TB. However, 70.2% (613) and 74.5% (650) of trained providers' knowledge and practice scores were equal to or more than the mean scores (≥6.97 and ≥6.6, respectively), whereas they were only 49.5% (435) and 64.2% (563), respectively, among untrained providers (p<0.0001).

Conclusions: Misperception, lack of knowledge and irrational use of antibiotics are challenges that need to be addressed for controlling and preventing TB efficiently.

Keywords: BRAC; Bangladesh; DOTS; Informal healthcare providers; TB.