Predictors of Tuberculosis outcomes amongst drug sensitive patients in Boteti sub-district, Botswana, 2015-2017.

INTRODUCTION: The. Boteti sub-district in Botswana has a high TB notification rate of 356 per 100 000 population in 2013, a Treatment completion rate of 55%, 13% cure rate, and 4% defaulter rate in 2014. The high TB notification and defaulter rates with lower cure and treatment success rates in this sub-district relative to the country, are indicative of certain determinants that may be hampering TB control. The aim of this study was to determine the factors associated drug sensitive TB treatment outcomes.

METHODS: A retrospective cohort study was conducted amongst all the new-smear positive adult pulmonary TB patients who registered and/or completed the treatment period at the six selected health-care centres in Boteti sub-district, between 1 January 2015 and 31 January 2017. An interviewer-administered questionnaire in the patient's language of choice- Setswana or English was utilised for data collection. Adjusted risk ratios (ARR) and their respective 95% confidence intervals (95% CI) were used for expressing associations.

RESULTS: Fifty-eight (56.9%) patients were successfully cured compared to 44 (43.1%) who successfully completed treatment. Patients that attended the clinics by foot (ARR 3.38) (P < 0.05), females (ARR: 1.25) and HIV negative patients (ARR: 1.20) were more likely to achieve TB cure. Patients that attended the facility with a vehicle were 2.12 (P < 0.000), a primary school and above education (ARR: 1.59), travelled less than 5 km (ARR: 1.05) and less than 38 years of age (ARR:1.02) were more likely to complete TB treatment.

CONCLUSION: A comprehensive health promotion approach based on the Ottawa charter principles to should be developed and implemented.