Pattern Of Childhood Tuberculosis In Sokoto, Northwestern Nigeria
Background: The incidence and mortality rate of tuberculosis (TB) has been on the decline until its recent resurgence worldwide, with Nigeria inclusive. Objectives: We, therefore, considered it worthwhile, for this area of the country, evaluating its prevalence/incidence. Furthermore, TB\'s main clinical features on presentation, variable forms, outcome and associated factors would be ascertained. Methodology: This was a 6-year retrospective study conducted in the Department of Paediatrics, Usmanu Danfodiyo University Teaching Hospital (between 1st December 1998 and 30th November 2004). All case files of children aged 3 months – 15 years of age with the diagnosis of any form of TB were retrieved from Medical Records Department. The data were analyzed in respect to age, gender, mode of presentation, history of BCG vaccination and evidence of its scar, main clinical findings, and results of investigations, complications, and outcome. Results: Ninety-nine (99) cases of TB were seen over the study period. Total patient on admission was 9,434, giving an overall prevalence rate of 1.1%, that is, about 1,100 per 100,000 populations. The male: female ratio encountered was 1.4: 1.0. Of the 99 cases, 45 (45.5%) were in age group 3months- 5years, 32 (32.3%) in >5years- 10years, and 22(22.2%) in >10 - 15.0 year-age-group. The main presenting features were cough, 55(55.5%), fever,53(53.5%) and weight loss 33(33.3%). The most predominant form of TB seen in this series was pulmonary involvement in 46(46.5%) of cases, followed next in rank by disseminated TB, 22(22.2%). The three commonest complications seen in this study were protein energy malnutrition (n= 21), severe anaemia (n=16) and pleural effusion (n=11). Majority of patients had short course anti-TB therapy with current drugs. The case-fatality rate identified was 10.1% (10/99). Fifty-three (53.5%) had complete course of the treatment and were normal thereafter, while 36 (36.5%) cases either signed against medical advice or defaulted from follow-up. Conclusion: Tuberculosis remains one of the major causes of mortality in Nigerian children, and it is, therefore, pertinent improving our socio-economic status, and diligently pursuing BCG vaccination of all children at stipulated periods.
Sahel Medical Journal Vol. 11 (4) 2008: pp. 110-113