الفهرس 
Introductionيوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Primary health care (PHC) play an essential role in TB control. CDC (2013,WHO (2014), and European (2015) guidelines stress the role of PHC in TB control. To assess the role of PHC in TB control (the aim of the study) in Gharbia governorate we carried out this study which was essentially questionnaire based. According the above guidelines we assessed 6 points in PHC units/centers in Gharbia governorate. These 6 points were:I- Basic knowledge of PHC physicians about TB through an eleven points questionair.II - Facilities for case detection: a working x-ray apparatus, smear staining for acid fast bacilli and availability of DOTS.III- Communication to central health authorities or a T.B specialist.
IV- Recording systems for proper patient management and follow up.
V - Follow up of patients after referral to central health units.
VI - Role in community education.
The data obtained were tabulated and statistically analyzed and the following results were obtained:
-Studied area includes 8 health territories and 40 primary care units (centers) with one physician in each unit.- Urban territories comprised 14 units (35%), rural territories comprised 26 units (65%) and only 100 patients were recorded in all units.- The % of the correct answers of the basic knowledge score ranged from 18% to 91%, with a mean of 49.6% and physicians in urban areas have higher scoring in basic knowledge than physicians in rural areas. -There were no working lab for sputum analysis or X- ray apparatus in all studied health units/centers but there was only availability of DOTS in all. -Case recording was lower in urban than rural areas (28.6% versus 73.1%).
-Recording system was higher and equal in Elmahala, Zfta (17.4%), then in Tanta, Basyon and Kotur (13.0%). While it was lower and equal in Kafr Elzaiat, Samanoud and Elsanta (8.7%).-Highest number of recorded TB patients was in Elmahala 29(29%) followed by Zfta 19(19%), Tanta 14(14%) and Kotur 12(12%) and Kafr Elzaiat 10(10%). The lowest number of recorded patients was in Basyon 8(8%), Elsanta 5(5%) and Samanoud 3(3%).-Communication with central health authorities in urban areas was higher than rural areas (71.4% versus 61.5%)
-Communication with central health authorities was higher in Tanta (19.2%),then equal in Zfta and Basyon (15.4%), then in Elmahala, Kafr Elzaiat and Kotur(11.5%).While the lowest was in Samanoud and Elsanta (7.7%).Patient follow up after referal to central health units was higher in rural than urban areas (11.5% versus 7.1%).- 88.5% of rural and 92.9% of urban were not followed up.
-Patient follow up after referral to central health units was higher in Elmahala (50%), then lower and equal in Zfta and Elsanta (25%). While there was no follow up for patient in Kafr Elzaiat, Tanta, Basyon, Kotur and Samanou-Participation in community education about TB was higher in urban than rural areas (78.6% versus 69.2%).-Participation in community education was higher and equal in Tanta, Zfta, Kotur (17.2%), then in Kafr Elzaiat (13.8%), then in Elsanta and Samanoud (10.3%), while it was lower in Elmahala and Basyon (6.9%). -76% of recorded cases were in rural areas while 24% were in urban areas.
Recorded patients showed that:
- TB in Males (56%) was higher than in females (44%).
- New cases were (97%).
- Most of cases in the age between (15-40) years (45%).
-Pulmonary cases were higher than extra-pulmonary cases (65% vs 35%).
-Sputum smear positive pulmonary tuberculosis cases were much higher than sputum smear negative pulmonary tuberculosis cases (76.9% vs 23.1%).-Most common site of extra-pulmonary tuberculosis was pleural tuberculosis (40%), followed by tuberculous lymphadenitis (25.7%).-75% of recorded cases were cured, 21% completed ttt, while 1% was ttt failure and 3% were died.