Clinical and Epidemiological Features of Childhood Tuberculosis in Ibadan

Abstract

Summary:. A prospective study of the clinical and epidemio logical features of childhood tuberculosis (Tb) in 193 children seen at the University College Hospital, Ibadan, over a four-year period has shown that 43 percent and 46 percent of the pa tients were in the age groups 1-5 years and 6-10 years, respectively. Although a history of contact was obtained in 21 percent of the cases, only four percent were diagnosed as a result of family. contact tracing. The duration of symptoms ranged from nine days to two years with a mean duration of 16 months. The disease was disseminated in 25 percent of cases while localized pulmonary Tb occurred in 42 percent. There was no difference in the occurrence of the severe forms of Tb among patients in whom BCG scars were seen and those who had not received BCG immunization. Chemotherapy default rates were 62% and 36% among patients on standard and short course chemotherapy, respectively. Post-mortem examination showed that 73 percent of 11 patients had the severe forms of the disease namely, meningitic, miliary and disseminated. Our. findings indicate that neonatal BCG immunization did not protect against severe forms of tuber culosis while other key control activities were poorly implemented. The high incidence of the severe forms of the disease may not be unrelated to the emerging HIV/AIDS pandemic, hence, routine screening of children with tuberculosis and their family contacts for HIV infection is recommended.