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Home-based treatment of childhood neurotuberculosis

Johan Schoeman1, Gerlinde Malan, Ronald van Toorn

  • 1Department of Paediatrics and Child Health, University of Stellenbosch, Western Cape, South Africa.

Journal of Tropical Pediatrics
|November 26, 2008
PubMed

Insights

Home-based treatment for childhood neurotuberculosis (TB) is feasible for selected patients. Mothers can effectively support directly observed therapy (DOT) at home, reducing hospital bed shortages.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • In-hospital treatment is standard for childhood neurotuberculosis due to care complexity.
  • Rising tuberculosis incidence and HIV pandemic cause hospital bed shortages.

Purpose of the Study:

  • To assess the feasibility of home-based directly observed therapy (DOT) for tuberculous meningitis (TBM).

Main Methods:

  • Suitability screening by social workers.
  • In-hospital monitoring of mother-child interaction and treatment tolerance.
  • Supervised outpatient surveillance program.

Main Results:

  • 85% of children (34/40) completed home-based TBM treatment successfully.
  • No patients defaulted from home-based treatment.
  • Mothers demonstrated capability as primary DOT supporters.

Conclusions:

  • Home-based treatment is a viable option for select pediatric neurotuberculosis cases.
  • Close supervision and maternal support are key to successful home-based TBM care.
Abstract

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