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 nearest health facility. Setting - Botswana national tuberclosis programme. Subjects - All patients with tuberculosis. Main outcome measures - Proportions of patients complying with and defaulting from treatment (missing ≥ 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.