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Journal of Tropical Pediatrics Advance Access originally published online on November 21, 2008
Journal of Tropical Pediatrics 2009 55(3):149-154; doi:10.1093/tropej/fmn097
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Home-based Treatment of Childhood Neurotuberculosis

Johan Schoemana, Gerlinde Malana, Ronald van Toorna, Priscilla Springera, Feroza Parkera and Judith Booysenb

aDepartment of Paediatrics and Child Health and
bDepartment of Social Services, Tygerberg Children's Hospital and Faculty of Health Sciences, University of Stellenbosch, Western Cape, South Africa

Correspondence: Ronald van Toorn, FC Paed, Department of Paediatrics and Child Health, PO Box 19063, Tygerberg 7505, South Africa. Tel.: 27 21 9389113; Fax: 27 21 938-9138. E-mail <vtoorn{at}sun.ac.za>.


  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.


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J Trop Pediatr 2009 55: i. [Full Text]  





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