Abstract
Tuberculosis (TB) is a disease of public health concern. According to the World Health Organisation (2020), about 10 million people fell ill with TB worldwide with 1.4 million deaths in 2019. TB is transmissible from one person to the next through droplets from cough and sneezing. With early treatment initiation and good adherence, transmission and prevalence are reduced. Good adherence to treatment also reduces mortality and the development of multi drug resistant TB.
The study determined the prevalence of TB and TB treatment non-adherence in Gaborone, Botswana. The study also aimed at determining the factors that contribute to TB treatment non-adherence and low treatment outcome in Gaborone, Botswana.
A quantitative cross-sectional retrospective design was employed in the study. TB documents that included registers and patients’ TB cards kept in health care government facilities were used to obtain data about TB patients in Gaborone. There were also study questionnaires distributed among TB focal persons in Gaborone government clinics asking about the factors that contribute to TB treatment non-adherence among TB patients. The research was carried out during the academic year 2021 – 2022.
SPSS was the software used for data analysis. Descriptive data analysis was used for data frequencies. Statistical correlation was used to determine the association between variables and TB treatment adherence.
A total of 132 TB patients were enrolled in the study retrospectively from the TB documents that were accessed in health facilities. 22 TB focal persons completed the questionnaire. There were more males (61.4%) than females (38.6%) and no difference between the number of HIV positive (48.8%) and HIV negative patients (47.3%). The majority of patients were new TB treatment cases suffering from pulmonary TB diagnosed with gene expert. Patients were mostly on community TB care (CTBC) and living within the local area to the clinics they were registered at.
The study determined that Gaborone has a high TB treatment adherence rate of 97.7%. Males were more likely to be adherent to treatment compared to females. TB focal persons perceived single patients (100%), being uneducated and unemployed risks to non adherence. They also perceived lack of support, stigma and discrimination and feeling better on treatment as factors that contribute to TB treatment non adherence. TB focal persons reported TB patients to have good knowledge about the symptoms of TB and the duration of treatment which are good predictors of good adherence. They also perceived themselves friendly and offering assistance in less than 30 minutes at their clinics.
Gaborone, Botswana has high TB treatment adherence rate. The partnerships with Non-Governmental Organisations (NGOs) such as Botswana Christian AIDS Intervention Programme (BOCAIP) and early transition to CTBC have been good initiatives for high adherence rate and need to be sustained.