Home-based treatment of childhood neurotuberculosis.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
Home-based treatment of childhood neurotuberculosis is feasible in selected patients under close supervision. Mothers could be considered as primary DOT supporters.
Schoeman
Johan
J
Department of Paediatrics and Child Health, University of Stellenbosch, Western Cape, South Africa.
Malan
Gerlinde
G
van Toorn
Ronald
R
Springer
Priscilla
P
Parker
Feroza
F
Booysen
Judith
J
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D023801:Directly Observed Therapy; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006792:House Calls; D006801:Humans; D008297:Male; D009035:Mothers; D010349:Patient Compliance; D016896:Treatment Outcome; D020306:Tuberculosis, Central Nervous System / Q000188:drug therapy*
D000995:Antitubercular Agents