Tuberculosis has remained a major challenge in the world, as new cases are reported each year.
The WHO reported that developing countries yield the most affliction of the disease and
associated fatalities. In Africa, Southern Africa (including Botswana) is mostly affected with
prevalence and incidence rates greater than that of the African average. Notification rates has
more than doubled in Botswana, from 226 per 100 000 in 1990 to 494 per 100 000 in 2009, with
Ghanzi district being the most afflicted. This district is dominated by the Bakgalagadi and the
Basarwa tribes. The Basarwa tribe is highly mobile (nomadic), illiterate and there is a language
barrier between them and the health care providers. This has lead to Basarwa tribe being linked
to these high prevalence and Incidences of Pulmonary Tuberculosis in the district.
The study aims to; (i) determine the variation in Pulmonary TB incidence and prevalence rates
between the nomadic Basarwa and the settled Bakgalagadi community, stratified by location of
residence, (ii) identifying the trend in Pulmonary TB incidence rate between the two ethnic
groups in the sub-district, and (iii) find out possible connections between nomadic lifestyle and
the prevalence of pulmonary TB in Gantsi sub-district. This is a descriptive analytic study and a
cross-sectional ecologic design was used. Data was analyzed statistically by descriptive and Auto
Correlation Function analysis.
There were 1907 cases of pulmonary TB included in this study; 723 occurred Basarwa
dominated regions and 1184 Bakgalagadi dominated region. The outcomes from this research
indicated that even when the pulmonary TB incidence in Gantsi sub-district is decreasing over
time, the prevalence is still high in other areas dominated by the Basarwa and the incidences
were higher in those areas than the Bakgalagadi dominated region. The incidences in males
(55.2%) where higher than that of females (44.8) in both regions, and the age category 25-34
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years registered the highest incidence rates in both groups. Auto Correlation Function
coefficients indicated the Basarwa dominated regions was positively correlated with PTB
incidence during the 2nd lag (r = 0.28), where else the Bakgalagadi dominated regions was
negatively correlated during both 1st and 2nd lags (r = -0.022 and -0.174 respectively).
With these results we cannot ignore TB susceptibilities that are brought up by ethnic differences
in the sub-district and this study suggests for in-depth researches both qualitative and
quantitative on pulmonary TB and ethnicity in the Gantsi sub-district. Recommendations are
suggested to the Botswana National TB programme to place more emphases on addressing
pulmonary TB among Basarwa to reduce the rates of infection in the district