Are Tuberculosis Patients Managed According to the National Guidelines in Lagos State Nigeria?

Setting: Private and public tuberculosis (TB) treatment centers in Lagos State, Nigeria. Objective: To compare adherence of private and public providers of directly observed treatment short course (DOTS) in the Lagos State TB control program, Nigeria (LSTBLCP) with the national TB guidelines. Design: A retrospective review of treatment cards of TB patients managed within the first and second quarter of 2012 in 34 DOTS facilities {23 public, 7 private for profit (PFP), and 4 private not for profit (PNFP)} involved in the private public mix of the LSTBLCP. Results: Of the 1896 treatment cards reviewed, 1524 (80.4%), 132 (7.0%) and 240 (12.6%) were from public, PFP and PNFP DOTS facilities, respectively. About 19%, 25% and none of the patients managed at the public, PNFP, and PFP DOTS facilities were treated in full adherence with the national guidelines respectively. A significantly higher proportion of adults and sputum smear positive TB patients were treated in full adherence with the national guidelines (p < 0.05). Treatment success was associated with full adherence with the national guidelines. Conclusion: There is a need to reorient health care providers in public and private health facilities in Lagos State Nigeria to ensure full adherence with the national TB guidelines.