Pattern of Diagnosis and Treatment of Childhood Tuberculosis in a Teaching Hospital in Southern Nigeria

The diagnosis of tuberculosis (TB) in childhood is challenging due to the paucibacillary nature of childhood TB and the difficulty in getting sputum samples from young children. The objective of this study was to determine the prevalence, diagnosis, anatomic type and treatment of tuberculosis in children admitted into the Paediatric ward. A retrospective review of clinical data of children admitted for tuberculosis in the paediatric ward of University of Uyo Teaching Hospital, Uyo, Nigeria from 2013-2017 was carried out. The data were analysed using STATA version 15.1.Among 3276 ward admissions, 32 patients (1.0%) had Childhood TB. There was a preponderance of TB in children aged 0-5 years (56.0%) with a male: female ratio of 2.6:1. Cough (71.9%), weight loss (63.0%) and fever (63.0%) were the commonest symptoms. Two out of 32 patients (7.0%) had a positive sputum Acid and Alcohol Fast Bacilli (AAFB) test and one out of five patients (20.0%) had a positive gastric aspirate GeneXpert result. The chest radiograph was suggestive of TB in 21 out of 25 patients (84.0%). Mean (SD) tuberculin skin test was 10±7mm. Pulmonary tuberculosis (67.0%) was the commonest form of TB seen. The six-month standard TB treatment option was the commonest regimen used as first-line in 28 out of 32 (88.0%) patients. Twenty five (78%) patients completed their treatment - the regime used was well tolerated. Our study has shown a 1% prevalence of Paediatric TB. There is therefore a need to tackle the issue of under diagnosis of childhood tuberculosis in our environment.