Javaid A Khan.
Tuberculosis control in Pakistan.
Pak J Chest Med May ;7(Suppl):37-40.

There are estimated 268,000 new cases and 64,000 deaths from TB each year in Pakistan. Pakistan bears 44% burden of TB cases in the whole of the WHO Eastern Mediterranean Region (EM RO). Pakistan`s National TB Program established in 1965 was suspended in 1985 due to insufficient resources from National and International sources. In 1994, Pakistan adopted the DOTS (Directly Observed Treatment, Short Course) strategy. The progress has been slow and until 1998, DOTS coverage of total population was only 8%. Although, the present government has taken several important steps in order to control the TB epidemic in this country, they are still not adequate. Following measures need to be taken in order to control the single largest infectious killer of Pakistan. The Private Sector Involvement: Pakistan has a large private health sector, and over 80% of TB patients first go to the private sector physicians for the diagnosis and treatment of their disease. Very little is known about the performance of physicians in the private sector of Pakistan. In one of our earlier studies, we found poor compliance with the National TB guidelines by the doctors working in a private teaching hospital of Pakistan. The fact remains that very few doctors working in the private sector are aware of the National TB Program of Pakistan. The government must devise methods at National and Provincial levels to involve doctors from the private sector in the TB control program. Some form of incentives would have to be given to the GPs, so that they follow the National Guidelines for TB control. This could include free sputum microscopy service, and free anti -TB drug provision to their TB patients. GPs in return should be asked to notify all TB cases to the relevant authorities in the TB control program, & should commit to direct observation of treatment under the DOTS strategy, at their respective centers. This is a review article.

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