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Case holding in patients with tuberculosis in Botswana
1Community Health Services Division, Epidemiology Unit, Gaborone, Botswana.
Objective:
To evaluate the effectiveness of daily supervised short course chemotherapy in a national tuberculosis programme.
Design:
Observation of programme during 1984-90. In October 1986 short course chemotherapy was introduced with patients receiving treatment daily from staff in their nearest health facility.
Setting:
Botswana national tuberculosis programme.
Subjects:
All patients with tuberculosis.
Main Outcome Measures:
Proportions of patients complying with and defaulting from treatment (missing > or = 43 days' treatment).
Results:
2938 cases of tuberculosis were recorded in 1990, 1528 of which were of sputum positive pulmonary disease. 2711 (92.3%) patients complied with treatment and 227 (7.7%) defaulted. Before introduction of short course chemotherapy compliance was about 60% compared with over 90% in 1987-90.
Conclusions:
A programme using daily supervised short course chemotherapy integrated into the primary health care system is an effective method of treating tuberculosis. The costs of the programme need to be evaluated.