Abstract:

Training enhances efficiency and develops a systematic way of performing duties. Community pharmacists are well-positioned as safety nets and can be trained to play a significant role in halting the progression of Tuberculosis (TB) disease. The study aimed at developing and evaluating the appropriateness of TB case detection and management training for community pharmacists in Lagos State, Nigeria. A one-day training to identify and refer individuals with TB symptoms to diagnostic facilities, was developed, conducted, and evaluated on a 5-point Likert scale, a semi-structured questionnaire, that was administered to 285 randomly sampled respondents. Participants’ opinion was rated on the training content, resource persons, and sufficiency of the training. The results of pre and post-tests were manually analyzed. Quantitative data were coded and analyzed using Statistical Package for Social Sciences Version 17. Descriptive statistics: percentage, frequency, mean and standard deviation were also used to analyze the data. Open-ended responses were analyzed thematically. The response rate was 67.02%. Respondents strongly agreed (47.37%) and agreed (46.05%) that the training was sufficient to enable community pharmacies to provide TB services in their pharmacy. Respondents expressed themselves on what they valued most about the training and made recommendations to improve and ensure the progress of the intervention. Exposure of community pharmacists to appropriate training significantly increased their knowledge in TB case detection and management. The training was fit for the purpose it was designed for. Community pharmacists could be a valuable asset in the prevention and control of TB in Nigeria.

References:

[1] United States Embassy in Nigeria, 2012, Tuberculosis Fact Sheet 2012, https://photos.state.gov/libraries/nigeria/487468/pdfs/JanuaryTuberculosisFactSheet.pdf//.

[2] FMOH: The National Strategic Plan for TB control, 2015.

[3] WHO, 2015, Tuberculosis: DOTS case detection rate 2015, https://www.who.int/whosis/whostat2006TuberculosisDOTSDetectionRate.pdf.

[4] World Health Organization, 2020, Global TB report, 2020, Geneva, Switzerland: WHO, https://www.who.int/publications-detail-redirect/9789240013131.

[5] Federal Ministry of Health National TB and leprosy control program annual report 2019, https://www.health.gov.ng/doc/Draft-2019-NTBLCP-Annual-report-22032020.pdf.

[6] World Health Organization, 2021, Gearing towards a TB free Nigeria- WHO and partners scale up action, https://www.afro.who.int/news/gearing-towards-tb-free-nigeria-who-and-partners-scale-action.

[7] The World Health Organization, 2023, Tuberculosis report, https://www.who.int/news-room/fact-sheets/detail/tuberculosis.

[8] TB Online: Information for Activists, patients, health workers and researchers working to end TB, www. tbonline.info/posts/category/Article.

[9] Government of India and India Pharmaceutical Association, 2013, RNTCP Training Modules for Community Pharmacists 2013. http://www.pci.nic.in/Circulars/Training%20Module.pdf.

[10] Konduri, N., Delmotte, E. and Rutta E., 2017, Engagement of the private pharmaceutical sector for TB control: rhetoric or reality? Journal of Pharmaceutical Policy and Practice, 10:6 DOI 10.1186/s40545-016-0093-3.

[11] Amrita, D., Nita, J., Madhukar, P., 2017, Enhancing the role of pharmacists in the cascade of tuberculosis care, Journal of Epidemiology and Global Health, 7(1), 1-4, ISSN 2210-6006, https://doi.org/10.1016/j.jegh.2016.05.001.

[12] Jakeman, B., Gross, B., Fortune, D., Babb, S., Tinker, D., Bachyrycz, A., 2015, Evaluation of a pharmacist-performed tuberculosis testing initiative in New Mexico, Journal of the American Pharmacists Association, 55(3), 307-312, ISSN 1544-3191, https://doi.org/10.1331/JAPhA.2015.14141.

[13] Gelband, H., Miller, Petrie, M., Pant, S., Gandra, S., Levinson, J., Barter, D., ... & Laxminarayan, R., 2015, The state of the world’s antibiotics 2015, Wound healing southern africa, 8(2), 30-34.

[14] Kotwani, A., & Holloway, K., 2011. Trends in antibiotic use among outpatients in New Delhi, India, BMC infectious diseases, 11, 1-9.

[15] Bell, C. A., Duncan, G. J., Eang, R., & Saini, B., 2015, Stakeholder perceptions of a pharmacy-initiated tuberculosis referral program in cambodia, 2005-2012, Asia Pacific Journal of Public Health, 27(2), NP2570-NP2577.

[16] Lonnroth, K., Lambregts, K., Nhien, D. T. T., Quy, H. T., & Diwan, V. K., 2000, Private pharmacies and TB control–a survey of case detection skills and reported anti-TB dispensing in private pharmacies in Ho Chi Minh City, Vietnam, International Journal of Tuberculosis and Lung Disease, 4, 1052-1059.

[17] Vu, D. H., Van Rein, N., Cobelens, F. G. J., Nguyen, T. T. H., Le, V. H., & Brouwers, J. R. B. J., 2012, Suspected tuberculosis case detection and referral in private pharmacies in Viet Nam, The International journal of tuberculosis and lung disease, 16(12), 1625-1629.

[18] Chalker, J., Chuc, N. T. K., Falkenberg, T., & Tomson, G., 2002, Private pharmacies in Hanoi, Vietnam: a randomized trial of a 2‐year multi‐component intervention on knowledge and stated practice regarding ARI, STD and antibiotic/steroid requests, Tropical Medicine & International Health, 7(9), 803-810.

[19] Hurtig, A. K., Pande, S. B., Baral, S. C., Porter, J. D. H., & Bam, D. S., 2000, Anti-tuberculosis treatment in private pharmacies, Kathmandu Valley, Nepal, The International Journal of Tuberculosis and Lung Disease, 4(8), 730-736.

[20] Bell, C. A., Eang, M. T., Dareth, M., Rothmony, E., Duncan, G. J., & Saini, B., 2012, Provider perceptions of pharmacy-initiated tuberculosis referral services in Cambodia, 2005–2010, The International journal of tuberculosis and lung disease, 16(8), 1086-1091.

[21] Rutta, E., Tarimo, A., Delmotte, E., James, I., Mwakisu, S., Kasembe, D., ... & Valimba, R., 2014, Understanding private retail drug outlet dispenser knowledge and practices in tuberculosis care in Tanzania, The international journal of tuberculosis and lung disease, 18(9), 1108-1113.

[22] Kalkidan, Y., 2016, Suspected Tuberculosis Patient Identification and Referral by Private Drug Retail Outlet Workers in South Wollo, Ethiopia Thesis submitted to University of Oslo for fulfillment of Master of Philosophy Degree in International Community Health, https://www.duo.uio.no/bitstream/handle/10852/52330/sosna.pdf?sequence=1&isAllowed=y.

[23] Okafor, U.G, Oreagba, I., 2019, Assessment of Level of Community Pharmacists’ Knowledge and Involvement in Tuberculosis Case Detection and Management in Lagos State, Nigeria, Texila International Journal of Public Health, 7(2).

[24] Darko, S., Plange, E. D., & Tetteh-Bator, E., 2020, Factors Contributing to Low Tuberculosis Case Detection in West Akim Municipality of the Eastern Region of Ghana; A Community and Health Facility Based Study, https://pdfs.semanticscholar.org/de9e/ee0ee026df52c232cb2c909ccb80528a0082.pdf.

[25] Harshit, T., 2012, Evaluation of Training and Development: An Analysis of Various Models, IOSR Journal of Business and Management (IOSR-JBM), ISSN: 2278-487X, 5 (2), 16-22, http://iosrjournals.org/iosr-jbm/papers/Vol5-issue2/B0521622.pdf.

[26] Suja, N.S., 2013, Health Ministry develops training module for community pharmacists under RNTCP 2013, http://pharmabiz.com/PrintArticle.aspx?aid=74734&sid=1.

[27] Gopal, Effectiveness of executive Training Programs, The Indian Journal of Commerce, 2008; 62(3):143-150.

[28] Nagar, V., 2009, Measuring Training Effectiveness, The Indian Journal of Commerce, 62(4): 86-90.

[29] UN World Urbanization Prospects, 2023, https://worldpopulationreview.com/world-cities/lagos-population.

[30] Adejumo, O. A., Daniel, O. J., Otesanya, A. F., & Adejumo, E. N., 2016, Determinants of health system delay at public and private directly observed treatment, short course facilities in Lagos State, Nigeria: A cross-sectional study, International Journal of Mycobacteriology, 5(3), 257-264, https://www.sciencedirect.com/science/article/pii/S2212553116300164.

[31] Adejumo, O. A., Daniel, O. J., Abdur-Razzaq, H. A., Shogbamimu, Y. O., Femi-Adebayo, T., Adepoju, V. A., ... & Sodipo, O. O., 2017, Trend of tuberculosis case notification and treatment outcome in Lagos State, Nigeria: a 5-year retrospective study, Transactions of the Royal Society of Tropical Medicine and Hygiene, 111(7), 300-307, https://academic.oup.com/trstmh/article-abstract/111/7/300/4643092.

[32] Adejumo, O. A., Daniel, O. J., Adejumo, E. N., Oluwole, E. O., & Olumuyiwa, O. O., 2015, Treatment outcomes of tuberculosis patients managed at the public and private DOTS Facilities in Lagos Nigeria, International Journal of Tropical Disease & Health, 10(2), 1-9, https://api-ir.unilag.edu.ng/server/api/core/bitstreams/c0e54ae4-9773-4ec2-8fe5-58534af124f8/content.

[33] Cochran, W. G., 1977, Sampling techniques (3rd ed.). New York: John Wiley & Sons.

[34] PCN: A list of Registered Pharmacists and Pharmaceutical Premises in Nigeria; A publication of the Pharmacists Council of Nigeria 2015.

[35] Shaira Alliah de Castro, Citation Preview: Curriculum planning sources and influences, https://www.scribd.com/presentation/475077775/Curriculum-planning-sources-and-influences and https://pdfcoffee.com/pec-103docx-pdf-free.html.

[36] Eliot & Associates, Guidelines for conducting a Focus Group 2005, https://assessment.trinity.duke.edu/documents/ How_to_Conduct_a_Focus_Group.pdf.

[37] Carolyn, B., Palena, N., 2006, Conducting In-depth Interviews: a guide for designing and conducting in-depth interviews for evaluation input, Pathfinder International Tool Series 2006, www.pathfinder.org/site/m_e_tool_series_indepth_interviews.pdf.

[38] Bajorek, B. V., Lemay, K. S., Magin, P. J. et al., 2015, Preparing pharmacists to deliver a targeted service in hypertension management: evaluation of an interprofessional training program, BMC Med Educ., 15:157 https://link.springer.com/article/10.1186/s12909-015-0434-y.

[39] Zahra, N. W., 2011, Survey on the knowledge Attitude and Practices on Tuberculosis among Healthcare workers in Kingston and St. Andrew, Jamaica, http://www.support.liverpoolonline.com/~/media/Files/UOLCSS/mph/MPH_Quantitative_Dissertation_2.pdf.

[40] Yejide O. O., Margaret O. A., 2020, Development and Evaluation of Health Promotion Training Program for Community Pharmacists in Oyo State, Nigeria, https://journals.sagepub.com/doi/abs/10.1177/2373379920918614.

[41] Parisa, A., Shalom, I. B., Ines, K., 2006, Development and evaluation of a training program to
foster the use of written drug information in community pharmacies 2006: Part 1–Development, https://pharmacyeducation.fip.org/pharmacyeducation/article/view/102/82.

[42] Saini, B., Smith, L., Armour, C., et al., 2006, An educational intervention to train community pharmacists in providing specialized asthma care, American journal of pharmaceutical education, 70(5): 118. https://doi.org/10.5688/aj7005118.

[43] Fitzgerald, N., Watson, H., McCaig, D. et al., 2009, Developing and evaluating training for community pharmacists to deliver interventions on alcohol issues, Pharm World Sci, 31:149–153.https://link.springer.com/article/10.1007%2Fs11096-009-9284-1#citeas.

[44] Lilly MDR-TB Partnership, 2014, Creating champions of change. Enrolling community pharmacists in a national tuberculosis control initiative, The Lilly MDR-TB Partnership, https://lillypad.lilly.com/WP/wp-content/uploads/CreatingChampions-of-Change.pdf.

[45] PATH, 2011, Public-private mix. Involving pharmacies and other providers in TB control – a Cambodia case study, https://www.path.org/publications/ files/CP_cambodia_ppm_tb_cs.pdf.

[46] Chemonics International, 2006, Philippine Tuberculosis Initiatives for the Private Sector Final Report, USAID Contract No. 492-C-00-02-00031.

[47] Morris, O., Freddy, E.K., Bush, H.A., et al., 2012, Strengthening Community Pharmacies Role in Early Tuberculosis Case Detection and Referrals – Case Study of Jinja Municipality, https://www.scribd.com/document/240247366.

[48] Bloch, R., Fox, S., Monroy, J., et al., 2015, Urbanisation and Urban Expansion in Nigeria. Urbanisation Research Nigeria (URN) Research Report. London: ICF, International Creative Commons Attribution-Non-Commercial-Share Alike CC, https://core.ac.uk/download/pdf/96701289.pdf.