The impact of patients' knowledge on using community-based tuberculosis care in the Lobatse District of Botswana

Abstract

Tuberculosis (TB), though declining, continues to be a global health problem fuelled by Human Immuno Deficiency Virus (HIV) infections. The dual TB/HIV epidemic in Sub-Saharan Africa (SSA) has necessitated re-thinking of economically viable TB control methods, including community-based TB care (CTBC). This study attempted to identify factors affecting patients‘ utilisation of CTBC in one district of Botswana in order to recommend ways to enhance the uptake of CTBC. Individual structured interviews were conducted with 101 TB patients in the Lobatse District of Botswana to identify their demographic characteristics, TB-related knowledge, attitudes concerning CTBC, support structures, factors influencing the adoption of a specific directly observed treatment (DOT) option as these factors could influence TB patients’ participation in the CTBC programme from January 2011 to August 2013. Univariate logistic regression models were used. Participation in CTBC was used as an outcome. The main predictors for participation in CTBC included, knowledge about and attitudes towards CTBC (p=0.0003), perceived barriers and enablers (p=0.0279) and patients’ satisfaction (p=0.0315) with the CTBC services. Identified barriers should be addressed and enablers strengthened to enhance TB patients’ utilisation of CTBC services.