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Journal of Tropical Pediatrics 1998 44(5):266-269; doi:10.1093/tropej/44.5.266
© 1998 by Oxford University Press
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Pediatric Tuberculosis in Rural South Africa—Value of Directly Observed Therapy

David Wilkinson, BSc, MBChB, DipPEC, DCH, DTMH, MSc(Epi)* and G. R. Davies, MB DTMH**

*Centre for Epidemiological Research in South Africa, South African Medical Research Council PO Box 187, Mtubatuba 3935 and Hlabisa Hospital South Africa and Division of Tropical Medicine, Liverpool School of Tropical Medicine UK
**Hlabisa Hospital, Hlabisa South Africa

Tuberculosis is a major cause of mortality and morbidity among children in resource-poor settings. A strategy of community-based, directly observed therapy employed in a rural health district in South Africa since 1991 is described. Most children (75 per cent) diagnosed with tuberculosis were treatedin the community and most of them (85 per cent) completed treatment Supervision was either by clinic-based health workers (26 per cent), community health workers (20 per cent), or volunteer lay people (46 per cent). Among children diagnosed with tuberculosis who were also HIV infected, the case-fatality rate was higher than among the HIV uninfected, and a larger proportion of the HIV infected failed to complete treatment.


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