PDF herunterladen
CC BY-NC-ND 4.0 · Libyan International Medical University Journal 2019; 04(01): 18-25
DOI: 10.4103/LIUJ.LIUJ_47_18
Original Article

Childhood tuberculosis in a South-East Nigerian tertiary hospital: Treatment outcomes and determinants

Chinyere Onubogu
Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
,
Ebele Ugochukwu
Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
,
Arthur Anyabolu
1   Department of Internal Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
,
Juliet Ojukwu
2   Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background and Objectives: Tuberculosis (TB) is an important cause of childhood morbidity and mortality. Understanding the barriers to successful childhood TB treatment is vital to curbing the scourge of childhood TB. This study examined the outcomes and factors that influence the outcomes of childhood TB treatment in a South-East Nigerian tertiary hospital. Methods: A 10-year review of the medical records of under-15 year olds, who received anti-TB treatment at Nnamdi Azikiwe University Teaching Hospital, Nnewi, was carried out. Data were analyzed using SPSS version 20. Results: Majority of the 501 childhood TB cases were new (89.6%) and pulmonary (73.3%) TB cases. TB-HIV coinfection occurred in 42.5% of cases. The rate of successful treatment was 62.9%. About 57.5% completed treatment, 5.4% were cured, 7.0% were transferred out, 21.4% were lost to follow-up, 0.4% had treatment failure while 8.4% died. Majority (61.6%) of deaths or loss to follow-up occurred during the first 2 months of treatment. Factors significantly associated with treatment outcomes were ascertainment of HIV status (P = 0.049), disease site (P = 0.013), nutritional status (P = 0.039), Mantoux test result (P = 0.002), and period of treatment (P = 0.005). Conclusion: Findings indicate high rate of unsuccessful childhood TB treatment outcomes. Efforts should be intensified to ensure improved outcomes through proactive search for childhood TB cases, early diagnosis and treatment, as well as adherence to and completion of treatment. Special attention should be given to high-risk groups including those with unknown HIV status, extrapulmonary TB, and severe malnutrition. It is imperative to determine the HIV status of all childhood TB cases.

Key-words:

Childhood tuberculosis - children - Nigeria - outcomes - treatment

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 04. November 2018

Angenommen: 04. März 2019

Artikel online veröffentlicht:
10. Juni 2022

© 2019. Libyan International Medical University. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 World Health Organization. Global TB Report 2017. Geneva: World Health Organization; 2017. Available from: https://www.who.int/gtbr2017_main_text. [Last accessed on 2018 Mar 20].
  • 2 World Health Organization. Tuberculosis Fact Sheet. Available from: http://www.who.int/mediacentre/factsheets/fs104/en. [Last updated on 2018 Jan 26].
  • 3 World Health Organization. Use of high Burden Country List TB by WHO in the Post-2015 era. Available from: http://www.who.int/tb/global_report/high_tb_burdencountries. [Last accessed on 2018 Mar 08].
  • 4 Ugochukwu EF. HIV/TB Co-infection in Nigerian children. Niger Med J 2010;51:120-4.
  • 5 World Health Organization. Roadmap for Childhood Tuberculosis: Towards Zero Deaths. Geneva: World Health Organization; 2013 Available from: https://www.who.int/tb/publications. [Last accessed on 2018 Mar 22]
  • 6 Dodd PJ, Yuen CM, Sismanidis C, Seddon JA, Jenkins HE. The global burden of TB mortality in children: A mathematical modeling study. Lancet Glob Health 2017;5:e898-906.
  • 7 World Health Organization. The End TB Strategy: Global Strategy and Targets for Tuberculosis Prevention, Care and Control after 2015. Geneva: World Health Organization; 2015.
  • 8 FMOH, NTBLCP. National Tuberculosis, Leprosy and Buruli Ulcer Management and Control Guidelines. Abuja: NTBLCP; 2015.
  • 9 Adejumo OA, Daniel OJ, Adebayo BI, Adejumo EN, Jaiyesimi EO, Akang G, et al. Treatment outcomes of childhood TB in Lagos, Nigeria. J Trop Pediatr 2016;62:131-8.
  • 10 Aketi L, Kashongwe Z, Kinsiona C, Fueza SB, Kokolomami J, Bolie G, et al. Childhood tuberculosis in a sub-Saharan Tertiary Facility: Epidemiology and factors associated with treatment outcome. PLoS One 2016;11:e0153914.
  • 11 Ogbudebe CL, Adepoju V, Ekerete-Udofia C, Abu E, Egesemba G, Chukwueme N, et al. Childhood tuberculosis in Nigeria: Disease presentation and treatment outcomes. Health Serv Insights 2018;11:1178632918757490.
  • 12 Adamu AL, Aliyu MH, Galadanci NA, Musa BM, Gadanya MA, Gajida AU, et al. Deaths during tuberculosis treatment among paediatric patients in a large tertiary hospital in Nigeria. PLoS One 2017;12:e0183270.
  • 13 Jiya NM, Bolajoko TA, Airede KI. Pattern of childhood tuberculosis in Sokoto, Northwestern Nigeria. Sahel Med J 2008;11:110-3.
  • 14 National Population Commission. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria: National Population Commission; 2013.
  • 15 Onubogu CU, Onyeka IN, Esangbedo DO, Ndiokwelu C, Okolo SN, Ngwu EK, et al. Changes in breastfeeding and nutritional status of Nigerian children between 1990 and 2008, and variations by region, area of residence and maternal education and occupation. Paediatr Int Child Health 2016;36:248-59.
  • 16 Babatunde OA, Elegbede OE, Ayodele M, Fadare JO, Isinjaye AO, Ibirongbe DO, et al. Factors affecting treatment outcomes of tuberculosis in a tertiary health center in Southwestern Nigeria. Int Rev Soc Sci Humanit 2013;4:209-18.
  • 17 Lolekha R, Anuwatnonthakate A, Nateniyom S, Sumnapun S, Yamada N, Wattanaamornkiat W, et al. Childhood TB epidemiology and treatment outcomes in Thailand: A TB active surveillance network, 2004 to 2006. BMC Infect Dis 2008;8:94.
  • 18 Jeena L, Naidoo K. Tuberculosis treatment outcomes among peri-urban children receiving doorstep tuberculosis care. Int J Tuberc Lung Dis 2016;20:235-9.
  • 19 Russell GK, Merle CS, Cooke GS, Casas EC, Silveira da Fonseca M, du Cros P. Towards the WHO target of zero childhood tuberculosis deaths: An analysis of mortality in 13 locations in Africa and Asia. Int J Tuberc Lung Dis 2013;17:1518-23.
  • 20 FMOH, NTBLCP. The National Strategic Plan for Tuberculosis Control 2015 – 2020: Towards Universal Access to Prevention, Diagnosis and Treatment. Abuja: NTBLCP; 2015.
  • 21 Mtabho CM, Irongo CF, Boeree MJ, Aarnoutse RE, Kibiki GS. Childhood tuberculosis in the Kilimanjaro region: Lessons from and for the TB programme. Trop Med Int Health 2010;15:496-501.
  • 22 World Health Organization. Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children. 2nd ed. Geneva: World Health Organization 2014.
  • 23 Sharma SK, Mohan A. Multidrug-resistant tuberculosis. Indian J Med Res 2004;120:354-76.
  • 24 Caminero JA. Guidelines for Clinical and Operational Management of Drug-Resistant Tuberculosis. Paris: International Union against Lung Disease; 2013.
  • 25 World Health Organization. Multidrug and Extensively Drug-Resistant TB (M/XDR-TB): 2010 Global Report on Surveillance and Response. Geneva: World Health Organization; 2010.