Do doctors in north-western Somalia follow the national guidelines for tuberculosis management?

A cross-sectional study assessed the knowledge and practices of registered practitioners in management of tuberculosis (TB) in north-western Somalia. Of 100 registered doctors, 53 were interviewed. Of these, 32 (64%) had treated TB patients during the previous year, but only 1 had notified the authorities, 33 (66%) knew the most important symptoms and 32 (64%) identified sputum smear microscopy as the most important diagnostic test. Only 4 doctors prescribed the correct regimen and only 7 advocate direct observation. Suboptimal knowledge was more common among doctors working in private practice (relative risk: 2.1; 95% CI: 1.1-4.3). Patients are being treated in the private sector, but few doctors follow national treatment guidelines. Training in diagnosis and case management is needed to improve TB control in Somalia.