SURVEY OF THE ROLE OF COMMUNITY PHARMACISTS IN THE MANAGEMENT OF TUBERCULOSIS IN DELTA

STATE

BY

OKUNGBA OGELENYA WHITELY

DELTA STATE UNIVERSITYABRAKA, NIGERIA

OCTOBER, 2015

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SURVEY OF THE ROLE OF COMMUNITY PHARMACISTS IN THE MANAGEMENT OF

TUBERCULOSIS IN DELTA STATE

BY

OKUNGBA OGELENYA WHITELYPHC/09/10/163524

A PROJECT SUBMITTED TO THE DEPARTMENT OF CLINICAL PHARMACY AND PHARMACY

ADMINISTRATION, FACULTY OF PHARMACY, DELTA STATE UNIVERSITY, ABRAKA, NIGERIA

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF THE DEGREE OF BACHELOR OF

PHARMACY (B.PHARM) DELTA STATE UNIVERSITY, ABRAKA

OCTOBER, 2015

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CERTIFICATION

This is to certify that this research project titled “Survey Of The Role Of Community

Pharmacists’ in the management of tuberculosis in Delta State” was carried out by

Okungba Ogelenya Whitely, under the supervision of DR J.E ARUTE(HOD) of the

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, Delta

State University, Abraka; and that it is adequate in scope and content for the partial

fulfillment of the requirement for the award of Bachelor of Pharmacy (B.Pharm) degree.

________________________________ __________________ OKUNGBA OGLENYA WHITELY DATE (Student Researcher)

___________________________ __________________ DR. J. E. ARUTE DATE (Project Supervisor)

__________________________ __________________DR. J. E. ARUTE DATE B.Pharm, PharmD, M.Pharm, FPC Pharm, MPSN (Head of Department)

________________________ __________________Prof. (Mrs.) C.V UKWE, PhD DATE(External Examiner)

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DEDICATION

This work is dedicated to God Almighty for his infinite mercies upon my life and my father

Late Chief Dennis Okungba for believing in me.

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ACKNOWLEDGEMENTS

My unending gratitude goes to God Almighty for his grace and loving kindness upon my life

for making the journey of a thousand miles to come a very victorious end.

My sincere gratitude goes to my outstanding supervisor, Dr J.E Arute (HOD clinical

Pharmacy and Pharmacy Administration) for his tremendous assistance, guidance and

support during the entire duration of my project. May God richly reward you sir for all your

efforts. My thanks are also extended to all staffs of the Faculty of Pharmacy, most especially

those in the Department of Clinical Pharmacy and Pharmacy Administration.

To the best things that have ever happened to me; My Late Father Chief Dennis Okungba and

my loving Mother Mrs. Comfort Okungba, thanks for all your love, care and support,

morally, financially, spiritually and otherwise. Words cannot express how much feelings I

hold for you,I love you plenty.

My special thanks also goes to my sweet wonderful uncle, Mr C.M.I Okungba and to my

amazing one and only brother Justice, and my sweet cousins Kenpolo, Ezekiel, Edmond and

Harrison. May God bless you all for me. And also extending deep appreciation to all my

amazing and wonderful friends who have contributed in numerous ways in my academic

pursuit and constructive criticism toward this work; Tega, Smiling J, Riquelme, Tonero,

Colabo Bishop Rume, Ike(EVOLUTION) Solo, Saso, Osasco tha Senator, Dj D.s.o ,Krixus

blaize, uchezzy, Orezi, Josh, the whole MSN Gang and my beautiful girlfriend Juan. And

also to all my wonderful course mates, God bless you all.

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TABLE OF CONTENTS

Title Page iCertification iiDedication iiiAcknowledgements ivTable of Contents viiList of Tables ixAbstract

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study 1

1.1.1 Epidemiology of Tuberculosis 2

1.1.2 History of Tuberculosis 3

1.1.3 Etiology of the Disease and Risk Factors 6

1.1.4 Types of Tuberculosis 7

1.1.5 Pathophysiology of Tuberculosis 8

1.1.7 Risk Factors 9

1.1.8 Treatments and Drugs 11

1.1.9 Drug Resistance in Mycobacterium Tuberculosis 14

1.2 Vaccine Management of Tuberculosis 16

1.2.1 Novel Approaches for Sub-Unit Vaccines 17

1.2.2 Hopes for Future Research 19

1.2.3 Drug-Susceptible Pulmonary Tuberculosis

20

1.2.4 Complications of Tuberculosis 21

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1.2.5 Special Populations 21

1.2.6 Prevention of Tuberculosis 23

1.2.7 Global Impact of Tuberculosis 24

1.2.8 The Pharmacist’s Role in Tuberculosis Management 25

1.3 Justification of the Study 26

1.4 Objectives of the Study 27

CHAPTER TWO: METHODS

2.1 Study Design 29

2.2 Research Setting 29

2.3 Study Population 31

2.4 Research Instrument 31

2.5 Data Collection Method 31

2.6 Data Analysis 31

CHAPTER THREE:

RESULT 32

CHAPTER FOUR

4.1 Discussion 47

CHAPTER FIVE

5.1 Conclusion 51

5.2 Recommendations 52

References 53

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LIST OF TABLES

Table: 3.1: Demographic Profile of Patients 34

Table 3.2 Attendance of TB Workshop, Seminars and Trainings 35

Table 3.3 Responses on Main Symptoms that are used as an indicator for infectious, active

TB disease 35

Table 3.4: Responses on whether someone can be infected with TB for more than once in

their life time 36

Table 3.5 Responses on the standard length of treatment for a newly diagnosed case of

TB 36

Table 3.6: Responses on TB curability 37

Table 3.7: Responses on WHO Classification Criterion for a Relapse case 38

Table 3.8: Responses on WHO classification criterion for a defaulter cases 39

Table 3.9: Responses on TB Referral Cases amongst Community Pharmacists 40

Table 3.10: Responses on TB as a Public Health Threat in Delta State 40

Table 3.11: Responses on TB Risk Persons 41

Table 3.12: Responses on TB Education 42

Table 3.13a: Responses on Primary Diagnostic Test 43

Table 3.13bImpact of Qualification on Preference of Diagnostic Test 44

Table 3.13cChi-Square Tests of Significant difference across Populations 45

Table 3.14: Responses on qualification needed by community pharmacists to effectively

conduct directly observed treatment 45

Table 3.15a: Responses on Most effective therapy for Patients with TB 46

Table 15b: Impact of Qualification on Most Effective Therapy Used 47

Table 15c: Chi-Square Tests of Significance on the Impact of Qualification on Choice of

Therapy 48

Table 3.16: Responses on Main risk to the patient associated with incomplete or

interrupted treatment course for TB 49

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ABSTRACT

The role of community pharmacists in the management of tuberculosis in Delta State was carried out. It employed the descriptive cross-sectional study design that accessed 85 Community Pharmacists’ knowledge, attitude and practice towards Tuberculosis and related treatments. The instrument used for the study was a self developed questionnaire while descriptive statistics and chi-square analysis was used for data analysis. Findings from the study revealed that there were limited cases of TB patients who consult Community Pharmacists. It also revealed that the knowledge base of community pharmacists on effective treatment and management was low while qualification had no significant (P>0.05) influence over their management practices. It was recommended amongst others that as essential collaborators in the health sector, Community pharmacists should always make themselves available for trainings and seminars so as to keep up to date their knowledge base and development in certain disease management while the pharmaceutical council of Nigeria should at intervals, promote development workshops and seminars for practicing pharmacists on advances, new trends and development in certain high risk factor diseases.

Key Words: Tuberculosis, Role, Community Pharmacist, Knowledge and Awareness

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