Suspected tuberculosis case detection and referral in private pharmacies in Viet Nam

D H Vu, N van Rein, F G J Cobelens, T T H Nguyen, V H Le, J R B J Brouwers
International Journal of Tuberculosis and Lung Disease 2012, 16 (12): 1625-9

SETTINGS: Private pharmacies in Hanoi, Viet Nam.

OBJECTIVES: To explore the response of health care providers (HCPs) in private pharmacies to suspected tuberculosis (TB) patients.

METHODS: A simulated patient method combined with an interview in 128 randomly selected private pharmacies and 10 private pharmacies near TB hospitals.

RESULTS: In the simulated patient method and interview, respectively 59 (46%) and 70 (55%) of HCPs referred the TB suspect to general health care. Only 11 (9%) referred the simulated patient to a TB care facility. Fifty-two (42%) of the HCPs identified suspected TB from a fictitious case described on paper; 34 (27%) were aware that free treatment was provided under the National Tuberculosis Programme (NTP). Knowledge about free NTP treatment predicted a higher rate of direct referrals to TB facilities (OR 5.80, 95%CI 1.88-19.62) and greater ability to identify suspected TB from a fictitious case on paper (OR 5.14, 95%CI 2.36-11.73). Pharmacies with Good Pharmacy Practice (GPP) certification were less likely to refer simulated patients to TB facilities than non-GPP pharmacies (OR 0.10, 95%CI ≤0.01-0.79).

CONCLUSIONS: Nearly half of HCPs in private pharmacies do not refer TB suspects, possibly contributing to delays in diagnosis and treatment. Knowledge about free NTP treatment predicted better performance of HCPs.

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