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Case holding in patients with tuberculosis in Botswana
1Community Health Services Division, Epidemiology Unit, Gaborone, Botswana.
BMJ (Clinical Research Ed.)
|August 8, 1992
Summary
Daily supervised short course chemotherapy significantly improved tuberculosis treatment compliance in Botswana. This approach, integrated into primary healthcare, proved effective in managing the disease.
Area of Science:
- Public Health
- Infectious Diseases
- Global Health
Background:
- Tuberculosis (TB) remains a significant global health challenge, requiring effective treatment strategies.
- National tuberculosis programmes are crucial for controlling TB spread and impact.
- Short course chemotherapy (SCC) is a standard treatment regimen for TB.
Purpose of the Study:
- To assess the effectiveness of daily supervised short course chemotherapy (SCC) within a national tuberculosis programme.
- To evaluate patient compliance and default rates associated with this treatment strategy.
Main Methods:
- An observational study of the Botswana national tuberculosis programme from 1984 to 1990.
- Introduction of daily supervised SCC in October 1986, with treatment administered at local health facilities.
- Measurement of patient compliance and default rates (defined as missing treatment for ≥43 days).
Main Results:
- In 1990, 2938 TB cases were recorded; 1528 had sputum-positive pulmonary disease.
- Patient compliance with daily supervised SCC reached 92.3% (2711 patients), a significant increase from approximately 60% before its introduction.
- Default rates decreased to 7.7% (227 patients) after the implementation of daily supervised SCC.
Conclusions:
- Daily supervised SCC, integrated into the primary healthcare system, is an effective strategy for treating tuberculosis.
- This approach significantly enhances patient compliance and reduces treatment default rates.
- Further evaluation of the programme's cost-effectiveness is recommended.