Home-based treatment of childhood neurotuberculosis

Schoeman J. ; Malan G. ; van toorn R. ; Springer P. ; Parker F. ; Booysen J. (2009)


Introduction: In-hospital treatment is widely recognized as the gold standard of treatment for children with neurotuberculosis due to the complexity of care and serious consequences of non-compliance. The continuous rise in the incidence of tuberculosis (TB), fuelled by an HIV-pandemic, has resulted in severe bed shortages in tertiary, secondary and TB hospitals in the Western Cape. Objective: To evaluate the feasibility of home-based directly observed therapy (DOT) in TBM. Method: Suitability screening by social workers, in-hospital monitoring of mother-child interaction, medication side effects and intolerance followed by a supervised outpatient surveillance program. Results: Forty of the 52 children screened were approved for home-based treatment. Thirty-four of these 40 patients (85%) completed TBM treatment successfully at home, and no patient defaulted treatment. Conclusion: Home-based treatment of childhood neurotuberculosis is feasible in selected patients under close supervision. Mothers could be considered as primary DOT supporters. © The Author [2008]. Published by Oxford University Press. All rights reserved.

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