Case holding in patients with tuberculosis in Botswana.

Abstract

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 nearesr 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 [is greater than or equal to[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.

Introduction

The Botswana national tuberculosis programme is unique in both its approach and its implementation. Short course chemotherapy is given to all patients who have tuberculosis diagnosed and treatment is supervised daily for the entire six months. This approach has achieved high …