Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Alex-Hart, B. A.; Paul, Nsirimobu Ichendu; Ugwu, RO

doi:10.4236/jtr.2019.72010

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Children acquire the disease by inhaling the TB bacteria released by an adult or close family member with open TB[ 1 ]. Older children may acquire the disease from close contact in schools[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria

Adepoju¹,

Adelekan²,

Agbaje³

et al. 2023

World J Clin Cases

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BACKGROUND Nigeria is one of the thirty high burden countries with significant contribution to the global childhood tuberculosis epidemic. Tuberculosis annual risk for children could be as high as 4% particularly in high tuberculosis (TB) prevalent communities. Isoniazid (INH) Preventive Therapy has been shown to prevent TB incidence but data on its implementation among children are scarce. AIM To determine the completion of INH among under six children that were exposed to adults with smear positive pulmonary TB in Lagos, Nigeria. METHODS This was a hospital-based retrospective cross-sectional review of 265 medical records of eligible children < 6 years old enrolled for INH across 32 private hospitals in Lagos, Nigeria. The study took place between July and September 2020. Data was collected on independent variables (age, gender, type of facility, TB screening, dose and weight) and outcome variables (INH outcome and proportion lost to follow up across months 1-6 of INH treatment). RESULTS About 53.8% of the participants were female, 95.4% were screened for TB and none was diagnosed of having TB. The participants’ age ranged from 1 to 72 mo with a mean of 36.01 ± 19.67 mo, and 40.2% were between the ages of 1-24 mo. Only 155 (59.2%) of the 262 participants initiated on INH completed the six-month treatment. Cumulatively, 107 (41.0%) children were lost to follow-up at the end of the sixth month. Of the cumulative 107 loss to follow-up while on INH, largest drop-offs were reported at the end of month 2, 52 (49%) followed by 20 (19%), 17 (16%), 11 (10.2%) and 7 (6.5%) at months 3, 4, 5 and 6 respectively. The analysis showed that there was no significant association between age, gender, type of facility and completion of INH treatment ( P > 0.005). CONCLUSION This study demonstrated suboptimal INH completion rate among children with only 6 out of 10 children initiated on INH who completed a 6-mo treatment in Lagos, Nigeria. The huge drop-offs in the first 2 mo of INH calls for innovative strategies such as the use of 60-d INH calendar that would facilitate reminder and early engagement of children on INH and their caregivers in care and across the entire period of treatment.

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Section: Introductionmentioning

confidence: 99%

Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria

Adepoju¹,

Adelekan²,

Agbaje³

et al. 2023

World J Clin Cases

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Prevalence, clinical characteristics, and treatment outcomes of childhood tuberculosis in Nigeria: a systematic review and meta-analysis

Ukoaka,

Daniel,

Wagwula

et al. 2024

BMC Infect Dis

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Background Tuberculosis (TB), caused by Mycobacterium tuberculosis , is a leading cause of infection-related deaths worldwide. Children with underdeveloped immune systems are particularly vulnerable, experiencing symptoms akin to common childhood illnesses. Early diagnosis and treatment typically yield positive outcomes. In Nigeria, childhood TB is underreported, complicating accurate burden assessment. This review synthesises and presents evidence on the disease prevalence among children in Nigeria, identifies clinical characteristics, and evaluates the effectiveness of treatment regimens and outcomes. Methodology A comprehensive systematic search across electronic databases was conducted to retrieve studies on the prevalence, characteristics, diagnostic criteria, and treatment outcomes of childhood tuberculosis in Nigeria. Study registration, data extraction and quality assessment followed standardized guidelines. The meta-analysis used a random-effects model to determine prevalence and mean treatment outcomes. Statistical heterogeneity was assessed using the I² statistic, and publication bias was evaluated with Egger’s test ( p = 0.127) and a funnel plot. Results This review and meta-analysis of 22 studies, primarily retrospective (77%) and cross-sectional (18.20%), involving 1,162,936 participants aged 0–18 years, found a pooled prevalence of 20.82% (95% CI: 8.55–36.64)) with high heterogeneity (I 2 = 99.88%). Pulmonary tuberculosis is the most common form in children 62.70% (95%: 43.57–80.03) diagnosed using sputum smear microscopy, GeneXpert MTB/RIF assays, chest radiographs, and tuberculin skin tests. Clinical diagnosis based on symptoms, contact history, and radiological findings is crucial for younger children unable to produce sputum, as laboratory tests confirm only 6% of cases. Treatment involves the use of rifampicin, isoniazid, pyrazinamide, and ethambutol per national and international guidelines. The meta-analysis showed an average treatment success rate of 75.47%%, but challenges such as loss to follow-up (11.40%)) and increasing mortality rates (6.76%) persist. Conclusion The burden of childhood tuberculosis in Nigeria is significant, even as diagnostic limitations pose constraints. The findings highlight the need for stronger health system collaborations to improve the quality of care offered to children diagnosed with TB. Future research should standardize diagnostic criteria and methodologies for consistent and reliable prevalence estimates. More longitudinal studies are necessary to comprehend the trend and pattern for the heightened prevalence and subpar treatment outcomes of childhood tuberculosis in Nigeria. PROSPERO ID CRD42024586765. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-024-10321-3....

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Addressing gaps in adolescent tuberculosis programming and policy in Nigeria from a public health perspective

Aduh

Ewa

Sam-Agudu

et al. 2021

International Journal of Adolescent Medicine and Health

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Objectives Tuberculosis (TB) is a leading infectious cause of death globally. Of the estimated 10 million people who developed active TB in 2019, 1.8 million (18%) were adolescents and young adults aged 15–24 years. Adolescents have poorer rates of TB screening, treatment initiation and completion compared to adults. Unfortunately, there is relatively less programme, research and policy focus on TB for adolescents aged 10–19 years. This article reviews the scope of health services and the relevant policy landscape for TB case notification and care/treatment, TB/HIV management, and latent TB infection for adolescents in Nigeria. Additionally, it discusses considerations for TB vaccines in this population. Content All Nigeria Federal Ministry of Health policy documents relevant to adolescent health services and TB, and published between 2000 and 2020 underwent narrative review. Findings were reported according to the service areas outlined in the Objectives. Summary and Outlook Nine policy documents were identified and reviewed. While multiple policies acknowledge the needs of adolescents in public health and specifically in TB programming, these needs are often not addressed in policy, nor in program integration and implementation. The lack of age-specific epidemiologic and clinical outcomes data for adolescents contributes to these policy gaps. Poor outcomes are driven by factors such as HIV co-infection, lack of youth-friendly health services, and stigma and discrimination. Policy guidelines and innovations should include adaptations tailored to adolescent needs. However, these adaptations cannot be developed without robust epidemiological data on adolescents at risk of, and living with TB. Gaps in TB care integration into primary reproductive, maternal-child health and nutrition services should be addressed across multiple policies, and mechanisms for supervision, and monitoring and evaluation of integration be developed to guide comprehensive implementation. Youth-friendly TB services are recommended to improve access to quality care delivered in a patient-centered approach.

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Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Cited by 4 publications

References 9 publications

Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria

Completion of 6-mo isoniazid preventive treatment among eligible under six children: A cross-sectional study, Lagos, Nigeria

Prevalence, clinical characteristics, and treatment outcomes of childhood tuberculosis in Nigeria: a systematic review and meta-analysis

Addressing gaps in adolescent tuberculosis programming and policy in Nigeria from a public health perspective

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