Investigation of Cysticercosis bovis prevalence using passive abattoir post-mortem inspection and active administration of structured non-participatory questionnaire to farmers in Botswana.

Most government published statistics of C. bovis prevalence in Botswana emanate mainly from records available at the Botswana Meat Commission (BMC), the country's national export abattoir. Although BMC slaughters 44% of Botswana's annual cattle slaughter, prevalence data arising from BMC does not reflect prevalence from lower throughput abattoirs and potential hotspots. Thus, reporting national prevalence rate using solely BMC statistics may not be very informative and reflective of the bigger picture. It therefore became imperative to probe prevalence of bovine cysticercosis using a cross-sectional study through passive abattoir inspection, covering a wider scope (more regions) and some lower throughput abattoirs previously not accounted for. Furthermore, non-participatory interview using structured questionnaires was employed to actively elicit prevalence information directly from meat industry stake holders. Prevalence arising from survey was used to compare and query results from statutory (traditional) passive abattoir method. Abattoir prevalence was 17.17% (SE = 1.70027), and survey prevalence was 42.35%; both of which were higher than published prevalence of 13.5% and BMC prevalence of 10% (SE = 0.006576). Survey method was more holistic than passive abattoir method, by covering more frontiers thus yielding higher prevalence. At p = 025, abattoir and survey prevalence were significantly different from each other. In addition to delimitating novel hotspots in Botswana, this study showed significant difference, p = 0.002 in prevalence within districts and regions. Kalagadi district's prevalence differed significantly from other districts: differed from North East at p = 0.042, Central district at p = 0.002 and Ghanzi at p = 0.004. The results which arise from this methodological approach have been able to provide a more all-inclusive and reliable prevalence rate.

Estimating the cost of care giving on caregivers for people living with HIV and AIDS in Botswana: a cross-sectional study.

BACKGROUND: Community home-based care is the Botswana Government's preferred means of providing care for people living with HIV (PLHIV). However, primary (family members) or volunteer (community members) caregivers experience poverty, are socially isolated, endure stigma and psychological distress, and lack basic care-giving education. Community home-based care also imposes considerable costs on patients, their caregivers and families in terms of time, effort and commitment. An analysis of the costs incurred by caregivers in providing care to PLHIV will assist health and social care decision makers in planning the most appropriate ways to meet future service needs of PLHIV and their caregivers. METHODS: This study estimated the cost incurred in providing care for PLHIV through a stratified sample of 169 primary and volunteer caregivers drawn from eight community home-based care groups in four health districts in Botswana. RESULTS: The results show that the mean of the total monthly cost (explicit and indirect costs) incurred by the caregivers was $(90.45 +/- 9.08) while the mean explicit cost of care giving was $(65.22 +/- 7.82). This mean of the total monthly cost is about one and a half times the caregivers' mean monthly income of $66.00 (+/- 5.98) and more than six times the Government of Botswana's financial support to the caregivers. In addition, the cost incurred per visit by the caregivers was $15.26, while the total expenditure incurred per client or family in a month was $184.17. CONCLUSIONS: The study, therefore, concludes that as the cost of providing care services to PLHIV is very high, the Government of Botswana should substantially increase the allowances paid to caregivers and the support it provides for the families of the clients. The overall costs for such a programme would be quite low compared with the huge sum of money budgeted each year for health care and for HIV and AIDS.