© 2020 Indian Journal of Respiratory Care | Published by Wolters Kluwer ‑ Medknow 58 Original Article INTRODUCTION Tuberculosis (TB) is among the top ten causes of mortality worldwide. In 2017, the global incidence of TB was estimated to be 10 million. [1] Since the past 5 years, TB has surpassed HIV/AIDS in becoming the leading cause of death from a single infectious agent. [2] India accounts for one-fourth of the global TB burden. [1,3] In 2017, the number of incident cases of TB was 211 per 100,000, and the number of deaths due to TB was 435,000. [3,4] Revised National Tuberculosis Control Program (RNTCP) is one of the largest national programs in India which provides free health-care services for TB patients. In spite of this government program, almost 85% of the patients having symptoms related to TB in urban India visit private practitioners (PPs) for their health-care needs, [5,6] and roughly, half of them (50%) ultimately receive treatment for TB outside the program. [7,8] To control this growing burden of disease, it is imperative that all TB patients receive the same quality of care, based on the best evidence available. The best practices for TB are enshrined in the International Standards of TB Care (ISTC). These standards were first published in 2006 followed by the second edition in 2009, and the third edition was released recently on World TB day 2014. [9] Based on the ISTC, several countries have drafted country‑specific adaptations, including the Standards for TB Care in India. [10] In spite of this, there is rampant usage of inappropriate diagnostic procedures and treatment practices for TB among the PPs in India. Furthermore, adherence to the ISTC continues to be low among them, [7,8,11-13] thereby causing delays in the diagnosis of TB and continuing disease transmission and development of resistance to existing drugs. [8,12,14] The study Assessment of Adherence to International Standards for Tuberculosis Care among Private Practitioners of Delhi Rashmi Agarwalla, Asna Jamal, Ekta Gupta, Rambha Pathak, Meely Panda, Faheem Ahmed Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India Context: Tuberculosis (TB) is among the top ten causes of mortality, and to control this growing burden of disease, it is imperative that all TB patients receive the same quality of care, based on the best evidence available. The best practices for TB as enshrined in the International Standards of TB Care (ISTC) if adhered to can expedite the efforts to control TB. Aims: The aim of the study was to evaluate the current practices for diagnosis and treatment of TB among the private medical practitioners against benchmark practices in ISTC and to assess the factors associated with adherence to ISTC. Subjects and Methods: A cross‑sectional study was conducted among fifty private practitioners (PPs) of Delhi over a period of 3 months. Data collection was done using a structured pro forma, and interviews were conducted privately in the PPs’ office. The key outcome variable was the proportion of practitioners adhering to the ISTC standards of diagnosis (standards: 1–6) and treatment (standards: 7–13). Results: Among fifty practitioners, 42% were found to be adherent, while 58% were found to be non‑adherent. Significant association was found between gender and any form of training/sensitization received in the Revised National Tuberculosis Control Program (RNTCP) (P < 0.05). Conclusion: As the adherence to the ISTC care among the PPs was poor, there is a need to train and give incentives to participating PPs in timely and regulated way. PPs play a key role in diagnosing and treating TB patients, and hence, timely training and orientation in RNTCP and standard treatment for TB care are essential and should be key priority areas. Keywords: Adherence, International Standards of Tuberculosis Care standards, private practitioners, tuberculosis Access this article online Quick Response Code: Website: www.ijrconline.org DOI: 10.4103/ijrc.ijrc_23_19 Abstract Address for correspondence: Dr. Ekta Gupta, G‑27/3 Rajouri Garden, New Delhi ‑ 110 027, India. E‑mail: ekta273@gmail.com This is an open access journal, and arcles are distributed under the terms of the Creave Commons Aribuon-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creaons are licensed under the idencal terms. For reprints contact: reprints@medknow.com How to cite this article: Agarwalla R, Jamal A, Gupta E, Pathak R, Panda M, Ahmed F. Assessment of adherence to international standards for tuberculosis care among private practitioners of Delhi. Indian J Respir Care 2020;9:58-61. Received: 21-05-2019 Revised: 27-06-2019 Accepted: 19-09-2019 Published: 08-01-2020 [Downloaded free from http://www.ijrc.in on Wednesday, November 16, 2022, IP: 122.180.177.97]