In an attempt to reach out to more patients, the Department of Medical Education has asked medical colleges in the city to refer their TB patients to the nearest Directly Observed Treatment Short course (DOTS) centre,a move welcomed by many while some doctors said the issue of accessibility to DOTS centres needs to be addressed.
In case of DOTS,the patient has to be physically present with the doctor while being administered. However,on some occasions,patients are unable to travel to the DOTS centre because of their physical and financial constraints. In such cases,their situation aggravates, a senior doctor from Lilavati Hospital said.
Non-adherence to treatment or drop-outs have been proven to increase drug-resistance among patients.
At present,there are 338 BMC-owned DOTS centres in the city spread across health posts,dispensaries and civic hospitals. However,patients usually choose to go to private practitioners first.
Bringing private doctors under the purview of the DOTS programme might not be entirely feasible. There needs to be a constant monitoring of the patient by the doctor,which a doctor at a private dispensary might not be able to do. It would help to train all private doctors so that they can refer the patients at the right time, said Dr Sharat Kolke,physician at Kohinoor Hospital. Following reports of Extra Extensive Drug Resistant (XXDR) TB cases in the city in January,civic health officials formed the Mumbai Blueprint as part of their anti-TB campaign.
A major part of the campaign was to rope in private practitioners under the Revised National TB Control Program (RNTCP).
A major chunk of TB patients first visit private doctors and then come to the public hospitals. Earlier,TB medicines under the prescribed under RNTCP were not available with the private doctors, said BMCs TB officer,Dr Mini Khetarpal.
However,in order to ensure all patients have access to treatment,we now provide subsidised medicines to private doctors as well. We hope that this will increase the accessibility of medicines, Khetrapal added.