Effectiveness of home-based directly obeserved treatment for tuberculosis in Kweneng West subdistrict, Botswana
Date
2010
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS Publishing
Abstract
Background: Tuberculosis (TB) and HIV are major public health problems in Botswana. In the face of growing TB notification rates, a low cure rate, human resource constraints and poor accessibility to health facilities, Botswana Ministry of Health decided to offer home-based directly observed
treatment (DOT) using community volunteers. Objectives: The aim of this study was to assess the outcomes of home-based directly observed
treatment (HB-DOT) versus facility-based, directly observed treatment (FB-DOT) in the Kweneng West subdistrict in Botswana and to explore the acceptability of HB-DOT among TB patients, community volunteers and health workers.
Method: A quantitative, observational study using routinely collected TB data from 405 TB patients
was conducted and combined with 20 qualitative in-depth interviews.
Results: The overall cure rate for smear-positive pulmonary TB patients was 78.5%. Treatment outcomes were not statistically different between FB-DOT and HB-DOT. Contact tracing was significantly better in FB-DOT patients. Interviews revealed advantages and disadvantages for both
FB and HB options and that flexibility in the choice or mix of options was important. A number of suggestions were made by the interviewees to improve the HB-DOT programme.
Conclusion: HB-DOT is at least as good as FB-DOT in terms of the treatment outcomes, but attention must be given to contact tracing. HB-DOT offers some patients the flexibility they need to adhere to TB treatment and community volunteers may be strengthened by ongoing training and
support from health workers, financial incentives and provision of basic equipment.
Description
CITATION: Kabongo, D. & Mash, B. 2010. Effectiveness of home-based directly obeserved treatment for tuberculosis in Kweneng West subdistrict, Botswana. African Journal of Primary Health Care & Family Medicine, 2(1): 1-6, doi: 10.4102/phcfm.v2i1.168.
The original publication is available at http://www.phcfm.org
The original publication is available at http://www.phcfm.org
Keywords
(DOT) Home-based directly observed treatment, HB-DOT programme, TB treatment
Citation
Kabongo, D. & Mash, B. 2010. Effectiveness of home-based directly obeserved treatment for tuberculosis in Kweneng West subdistrict, Botswana. African Journal of Primary Health Care & Family Medicine, 2(1): 1-6, doi: 10.4102/phcfm.v2i1.168