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 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.