SURVEY OF THE ROLE OF COMMUNITY PHARMACISTS

IN THE MANAGEMENT OF TUBERCULOSIS IN DELTA

STATE

BY

OKUNGBA OGELENYA WHITELY

DELTA STATE UNIVERSITY

ABRAKA, NIGERIA

OCTOBER, 2015

SURVEY OF THE ROLE OF COMMUNITY

PHARMACISTS IN THE MANAGEMENT OF
TUBERCULOSIS IN DELTA STATE

BY
OKUNGBA OGELENYA WHITELY
PHC/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

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
(Student Researcher)

__________________
DATE

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

__________________
DATE

__________________________
DR. J. E. ARUTE
B.Pharm, PharmD, M.Pharm, FPC Pharm, MPSN
(Head of Department)
________________________
Prof. (Mrs.) C.V UKWE, PhD
(External Examiner)

__________________
DATE

__________________
DATE

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.

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.

TABLE OF CONTENTS

Title Page
Certification
Dedication
Acknowledgements
Table of Contents
List of Tables
Abstract
CHAPTER ONE:

i
ii
iii
iv
vii
ix

INTRODUCTION

1.1

Background of the Study

1.1.1

Epidemiology of Tuberculosis

1.1.2

History of Tuberculosis

1.1.3

Etiology of the Disease and Risk Factors

1.1.4

Types of Tuberculosis

1.1.5

Pathophysiology of Tuberculosis

1.1.7

Risk Factors

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

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 Pharmacists 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
7

4.1

Discussion

47

CHAPTER FIVE
5.1

Conclusion

51

5.2

Recommendations

52

References

53

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
Table 3.4:

35

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

their life time

Table 3.5

36

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:

40

Responses on TB Referral Cases amongst Community Pharmacists

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

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

10