Private Pharmacies Boost Tuberculosis Detection in Pakistan

The World Health Organization (WHO) has long suggested that local pharmacies are an underused health resource that could do more for community healthcare. Building on that idea, a team led by corresponding author Zikria Saleem set out to test whether private pharmacies in Pakistan could help find people with tuberculosis (TB) sooner. The study focused on identifying and referring people who showed obvious TB symptoms or who had a chronic cough for more than two weeks. Rather than relying only on clinics and hospitals, researchers reached into the places where many people first seek help: private, community pharmacies. The aim was straightforward — see whether these pharmacies could spot likely TB cases and send them to nearby centers of the National TB Control Program (NTP) for diagnosis. By inviting pharmacies to take an active role in referral and by monitoring the outcomes, the study tested a practical, low-cost way to expand the front lines of TB case finding without creating parallel systems. The work reflects a public health approach that links everyday health businesses with national TB services to close gaps in detection.

The study contacted 398 private pharmacies in five major districts of Pakistan and asked them to refer patients with apparent TB symptoms or a chronic cough for more than two weeks to the nearby center of the National TB Control Program (NTP). Pharmacy students were involved in monitoring and following up with patients to track the results of diagnostic tests. Of the 398 enrolled pharmacies, 224 pharmacies (56.28%) produced referrals. Across those pharmacies a total of 994 TB suspects were referred for tests. Of those referred, 839 individuals (84.4%) actually appeared for TB examination tests while 155 people (15.5%) did not show up and were counted as missing. Among the 839 tested suspects, 189 people (22.5%) were diagnosed with smear positive TB. Those figures show both the promise and the practical challenges of using pharmacies to feed the official diagnostic system: a substantial number of referrals translated into confirmed smear positive TB diagnoses, but not every enrolled pharmacy participated and some referred patients did not complete testing.

The findings suggest that community pharmacies, working under a thematic model of public private partnership, can play a meaningful role in tracing, preventing and achieving earlier diagnosis of TB. With more consistent participation from pharmacies and follow-through from referred patients, the number of cases found by screening at these community points could rise. The study also highlights gaps that need attention: only 56.28% of enrolled pharmacies produced referrals, and 15.5% of referred suspects did not present for testing, indicating barriers such as awareness, logistics or follow-up that must be addressed. The authors conclude that the project could be extended and implemented across all provinces of Pakistan, provided there are additional technical and financial inputs into the existing system. Scaling up would mean training and supporting pharmacy staff, strengthening referral links to the NTP, and dedicating resources to follow-up so that early detection leads promptly to diagnosis and care, advancing efforts to control and ultimately eradicate TB.