Outcome of Childhood Tuberculosis at a Specialist Hospital in Gusau, Nigeria

Introduction: Tuberculosis (TB) is a chronic infectious disease that is preventable and curable, yet a major cause of childhood morbidity and mortality. Tuberculosis prevalence and mortality are under-estimated in many high burden countries. Directly Observed Treatment Short course (DOTS) enhances treatment outcome with an overall reduction in morbidity and development of multidrug resistant TB.

Objective: To determine the pattern and outcome of childhood tuberculosis managed at the DOTS clinic in Gusau, Nigeria.

Methodology: A retrospective study of children managed for TB at the DOTS clinic over a 30 months period. The clinic serves both children and adults. All children (≤ 18years) treated for tuberculosis over the study period were included. Relevant information from the register was retrieved and analysed accordingly. Treatment outcomes were assessed according to World Health Organisation (WHO) and National Tuberculosis and Leprosy Control Programme (NTLCP) guidelines. “Cured’’ and “treatment completed’’ outcomes were classified as treatment successful.

Results: Of the 415 patients managed, 76(18.3%) were children; males were 30(39.5.2%), with a M: F ratio of 1:1.5. Mean±SD age was 8.89±5.38 years, with 29(38.2%) being in the 0-5 years age group. Pulmonary TB (PTB) was seen in 58(76.3%), more females had pulmonary TB than males, which was not significant (χ2=1.350, p=0.245). Seventy-five (98.7) were new cases, with 1(1.3%) treatment after failure.

Acid-fast bacilli (AFB) were positive in 12(15.8%) while GeneXpert MTB/RIF sensitivity was detected in 7(9.2%). Majority 51(67.1%) completed treatment, 12(15.8%) were cured, 9(11.8%) were transferred out, 3(3.9%) died, while 1(1.3%) was lost to follow up; with the successful outcome of 82.9%.

Conclusion: Treatment outcome using DOTS strategy was excellent, with a success rate close to 85.0% of WHO benchmark. The proportion of childhood TB indicates that childhood TB as compared to the adult cases is still under diagnosed and undertreated.