title: Home-based treatment of childhood neurotuberculosis.
abstract: 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.
authors.affiliation: Department of Paediatrics and Child Health, University of Stellenbosch, Western Cape, South Africa.
authors.forename: Johan
authors.initials: J
authors.lastname: Schoeman
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Malan
authors.forename: Ronald
authors.initials: R
authors.lastname: van Toorn
authors.forename: Priscilla
authors.initials: P
authors.lastname: Springer
authors.forename: Feroza
authors.initials: F
authors.lastname: Parker
authors.forename: Judith
authors.initials: J
authors.lastname: Booysen
mesh_terms: 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*
chemical_list: D000995:Antitubercular Agents