TY - JOUR T1 - How Do Private Providers Unaffiliated With the Nigeria National TB Program Diagnose and Treat Drug-Susceptible TB Patients? A Cross-Sectional Study JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-22-00210 VL - 10 IS - 6 SP - e2200210 AU - Victor Abiola Adepoju AU - Ademola Adelekan AU - Victoria Etuk AU - Moses Onoh AU - Babatunde Olofinbiyi Y1 - 2022/12/21 UR - http://www.ghspjournal.org/content/10/6/e2200210.abstract N2 - Key FindingsA majority of Nigerians seek TB care from the private sector, yet private providers who are not affiliated with the National TB Program (NTP) do not receive training on guidelines for diagnosis and treatment.Nearly 40% of private unaffiliated providers we surveyed self-reported using acid-fast bacilli for TB diagnosis. However, a much larger percentage used 5 other TB testing approaches not approved by the NTP to make a definitive diagnosis.Only 32.4% of providers surveyed prescribed the correct drug regimens. Five of the treatment regimens reported in our study contained streptomycin, which is against NTP recommendation.Key ImplicationsThe enormous gaps in the quality of TB diagnosis and treatment among unaffiliated NTP providers in this study have wider implications for TB control efforts, particularly case notification, spread of drug-resistant TB strains, cost of prescribing unnecessary tests, and prolonged treatment duration.National and subnational TB program managers need to prioritize the rapid engagement of non-NTP providers into NTP surveillance systems, routine TB update trainings, and supportive supervision and monitoring to help increase the quality of their services.Introduction:TB diagnosis and treatment practices among private providers not affiliated with the Nigeria National TB Program (NTP) have implications for TB control efforts. Studies evaluating these practices among non-NTP providers are scarce. We aimed to investigate TB diagnosis and treatment practices among non-NTP private providers in urban Lagos State, Nigeria.Methods:We conducted a cross-sectional study among doctors and nurses operating private facilities not formally affiliated with the NTP for TB case notification. Between May 2018 and January 2019, we implemented a survey using a pretested questionnaire among 152 doctors and nurses attending TB sensitization seminars in Lagos, Nigeria. We used descriptive statistics to summarize the sociodemographic information and proportion of non-NTP providers with different self-reported TB diagnostic, prescription, and monitoring practices.Results:Private non-NTP doctors and nurses self-reported diagnosing TB using 8 different types of tests. Acid-fast bacilli was the most common (39.8%) means of diagnosing TB. Private non-NTP providers also self-reported prescribing 23 different TB regimens, including streptomycin, to treat TB. Only 32.4% of providers self-reported using the correct combinations of anti-TB drugs to treat TB. Additionally, 58.3% of providers prescribed the standard 6-month treatment duration for pulmonary TB patients, and the remaining 41.7% either undertreated or overtreated TB.Conclusion:A large proportion of private doctors and nurses not formally affiliated with the NTP in Nigeria were not following the NTP guidelines in the diagnosis and treatment of TB. Overtreatment and undertreatment were common. Engagement of these practitioners by the NTP in the form of supervision, on-the-job mentorship, and other strategies can mitigate the negative effects of their current practices on TB case notification and the spread of drug-resistant strains in Nigeria. ER -