Management of Childhood Tuberculosis: The Experience in a Tertiary Health Care Facility in Nigeria.

Abstract

Tuberculosis (TB) is a public health problem globally and Nigeria ranks fifth among countries with highTB burden world-wide. Tuberculosis in children accounted for 15-40% and 2-7% of cases in developing and developed countries respectively. The study was undertaken to document the pattern of presentation and management of TB in children in a tertiary health facility in Maiduguri. A retrospective review of case files of children (aged 0-15 years) who were managed for TB at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria, over a four year period was conducted in April and May, 2009. One hundred and sixteen children were managed for various forms of TB, out of total admission of 8582, giving a prevalence of 1.35%. The age of the study group ranged from 4 months to 14 years, median (IQ) age was 24 (12-58) months. Children in the low socio-economic class (SEC) were observed to be significantly more than those in the upper class. The common presenting symptoms were fever, chronic cough and weight loss, and 66 (57%) of the cases studied were HIV co-infected. While pulmonary TB, disseminated TB and TB adenitis accounted for 87(75%), 24(20.7) and 5(4.3%) cases respectively, no case of TB abdomen was recorded. Ninety five (81%) children completed 6-12 months of anti-TB treatment, which was tolerated well by the children. The prevalence of TB among children of low SEC is high, so also among HIV infected children. Prompt TB screening of all patients with suspected symptoms and signs of TB as well as evaluation of TB patients for HIVinfection is recommended.

Key words: Childhood, Tuberculosis, Maiduguri, Management.