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Anti-tuberculosis treatment in private pharmacies, Kathmandu Valley, Nepal
A K Hurtig1, S B Pande, S C Baral
1Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, UK. a.hurtig@lshtm.ac.uk
Setting:
Urban municipality of 150000 citizens in Kathmandu Valley, Nepal.
Objective:
To determine 1) the perceptions among private pharmacists of characteristics of tuberculosis (TB) patients visiting private pharmacies in the area, 2) the sales of different anti-tuberculosis drugs, and 3) the interaction between private health providers and pharmacists.
Design:
Between January and April 1998, semi-structured interviews were conducted with 98% (49/50) of the private drug-retailers in the area.
Results:
Thirty-two (65%) pharmacies had sold anti-TB drugs during the last month. Forty-three (88%) said that most TB patients were of low socio-economic status and rarely bought drugs for more than a week at a time. Only eight (16%) reported that TB patients usually returned to buy the full course of drugs. Seventy-two per cent of total spending on anti-tuberculosis drugs was for different kinds of combinations of drugs. Nine per cent was spent on plain rifampicin, believed to be sold only to tuberculosis/leprosy patients. During the previous month, 5/13 (38%) of pharmacies with no doctors attached had sold anti-tuberculosis drugs compared with 27/38 (71%) of pharmacies with doctors attached to them (P < 0.05).
Conclusion:
The private sector offers an available and acceptable but non-affordable service for many TB patients. A substantial amount of anti-TB drugs are being sold in the private pharmacies. There is therefore a potential role for pharmacists to play in collaborative efforts between the private and public sector in TB control activities.