A treatment-support intervention evaluated in South African paediatric populations with HIV infection or tuberculous meningitis

Sabine L. van Elsland, Remco P.H. Peters, Maarten O. Kok, Ronald van Toorn, Priscilla Springer, Mark F. Cotton, Cornelis J. Grobbelaar, Rob Aarnoutse, A. Marceline van Furth

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2 Citations (Scopus)


Objectives: To evaluate a paediatric treatment-support intervention for home-based treatment of HIV infection or tuberculous meningitis (TBM). Methods: A randomised-controlled study comparing local standard care (controls) with standard care plus intervention (combining adherence education, reinforcement and monitoring) in children aged 0–14 years. We recorded adherence measures (self-report, pill-count, drug-assays for isoniazid and rifampicin in urine and pyrazinamide in saliva), difficulties administering medication and PedsQL™questionnaires for health-related quality-of-life (HRQoL) and family impact. Results: In the HIV group (6-months follow-up, n = 195), more children had above-median HRQoL-scores in the intervention group than in the control group (P = 0.009). Problems reported administering medication declined between baseline and follow-up for controls (P = 0.043). Disclosure of HIV status to the child increased between baseline and follow-up in both groups (intervention P < 0.001; control P = 0.031). In the TBM group (3-months follow-up, n = 43), all adherence measures remained high for both intervention and controls, except for rifampicin which declined between baseline and follow-up in the intervention group (P = 0.031). The intervention group maintained above median HRQoL-scores between baseline and follow-up, when the number of children with above-median HRQoL-scores decreased in the controls (P = 0.063). More children in the intervention group had above-median family impact-scores than controls (P = 0.040). Conclusions: The low-cost, culturally friendly treatment-support intervention had beneficial effects on health-related quality of life, family impact, caregiver disclosure of HIV status to the child, increased caregiver reporting of medication non-adherence and caregiver reporting of difficulties administering medication. Treatment adherence was not significantly affected in either HIV or TBM group.

Original languageEnglish
Pages (from-to)1129-1140
Number of pages12
JournalTropical Medicine and International Health
Issue number10
Early online date3 Aug 2018
Publication statusPublished - 1 Oct 2018


  • HIV
  • Paediatric
  • Tuberculous meningitis
  • child
  • intervention
  • treatment-support

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