CASE HOLDING IN PATIENTS WITH TUBERCULOSIS IN 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 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.