Spectrum of tuberculosis in children at Federal Medical Centre, Gusau, Zamfara State, Northwestern Nigeria

Abstract

Background: Children contribute a significant proportion of tuberculosis (TB) burden and suffer severe morbidity and mortality, particularly in endemic areas. The diagnosis of TB in children can be challenging because TB can mimic many common childhood diseases, and therefore, high index of suspicion is required to improve detection of cases. Aims: To determine the prevalence and pattern of TB in children at Federal Medical Centre, Gusau. Subjects and Methods: A retrospective study in children aged 4 months to 13 years admitted to the pediatrics medical ward with TB (over a 1 year period) in the year 2008. Results: Of the 1392 children admitted over this period, 67 were suspected cases of TB, giving a prevalence of 4.8%. Six (9%) patients had TB-human immunodeficiency virus co-infection. Only 6 (9%) children received Bacille-Calmette–Guerin (BCG) vaccine. Disseminated TB (DTB) accounted for 34 (50.7%) of the 67 cases, pulmonary TB was present in 26.9% while 9 (13.4%) had spinal TB. Forty (59.7%) patients successfully completed treatment, 15 (22.4%) were lost to follow-up, and 7 (10.4%) died in the course of treatment. Three (4.5%) defaulted and were retreated while 2 (3%) were referred. Conclusion: The prevalence of childhood TB was 4.8% with low BCG vaccine uptake. DTB was the predominant form, followed by pulmonary and spinal TB. Significant proportion of children successfully completed their treatment regimen while case fatality rate was 10.4%.

Keywords

• Childhood tuberculosis
• disseminated tuberculosis
• prevalence of tuberculosis
• pulmonary tuberculosis