Tuberculosis; Primary Health Care; National TB Control Program
Abstract Objective: The aim of this work was to evaluate the Primary Health Care service performance in National Tuberculosis Control Program in Qalyubia Governorate. Methods: The studied area (Qalyubia Governorate) includes 8 health territories (each contains 5 primary care units/centers). A questionnaire based on 6 parameters was used to evaluate the PHC system performance: 1 - Physicians with basic knowledge about TB (causative agent, methods of spread, clinical picture, essential steps in investigations: X-ray and sputum smear). II - Facilities for primary investigation (sputum examination and chest X-ray), III - Communication with the central health authorities or a TB specialist, IV - Proper recording systems needed for proper patient management and follow up, V - Follow up schedules are available for the detected patients, VI - Have a role in community education about the disease. The data obtained were tabulated and statistically analyzed. Results: Studied area included 8 health territories and 40 primary care units (35% were urban and 65% rural) with one physician in each unit. The mean percent of the correct answers of the basic knowledge score was 48.2% (range = 18%-100%), higher in urban units physicians than rural units physicians, with lack of proper laboratory (for sputum analysis) or X-ray apparatus. Communication with central health authorities in urban areas was higher than rural areas (65.4% versus 57.1%). Case recording was lower in urban than rural areas (42.9% versus 462%). Patient follow up after referral to central health units was higher in rural than urban areas (11.5% versus 7.1%). Participation of community education was 78.6% in urban units and 76.9% in rural units.
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