Home-based treatment of childhood neurotuberculosis

Date
2009
Authors
Schoeman J.
Malan G.
van toorn R.
Springer P.
Parker F.
Booysen J.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
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.
Description
Keywords
ethambutol, ethionamide, isoniazid, prednisone, pyrazinamide, rifampicin, tuberculostatic agent, adolescent, article, caregiver support, central nervous system tuberculosis, child, clinical article, directly observed therapy, drug substitution, drug withdrawal, evening dosage, feasibility study, female, home based directly observed therapy, home care, hospital readmission, human, male, morning dosage, mother child relation, nausea and vomiting, outcome assessment, patient compliance, patient selection, survivor, treatment response, vomiting, Adolescent, Antitubercular Agents, Child, Child, Preschool, Community Health Services, Directly Observed Therapy, Female, Home Care Services, House Calls, Humans, Male, Mothers, Patient Compliance, Treatment Outcome, Tuberculosis, Central Nervous System
Citation
Journal of Tropical Pediatrics
55
3