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Published on: September 5, 2017
Trend in childhood tuberculosis in Benin City, Nigeria
1Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Insights
Childhood tuberculosis cases rose significantly from 1981 to 1995, with a shift towards adult-type disease. Increased severity, including hemoptysis and finger clubbing, was observed in pediatric tuberculosis patients.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Epidemiology
Background:
- Childhood tuberculosis presents unique diagnostic and management challenges.
- Understanding temporal trends in pediatric tuberculosis is crucial for public health interventions.
Purpose of the Study:
- To analyze the trends and clinical patterns of childhood tuberculosis over a 15-year period.
- To identify changes in disease severity and presentation in pediatric tuberculosis cases.
Main Methods:
- Retrospective review of case records of children diagnosed with tuberculosis.
- Analysis of data from January 1981 to December 1995 at a university teaching hospital.
- Statistical evaluation of case proportions, clinical patterns, and disease severity indicators.
Main Results:
- Tuberculosis accounted for 11.6% of pediatric medical cases, with a steady increase in proportion from 6.9% to 22.1% over the study period.
- A shift towards adult-type tuberculosis, characterized by disseminated and cavitating lesions, was observed.
- Disease severity increased, with hemoptysis rising from 1.6% to 14.2% and finger clubbing from 1.6% to 18.2%.
Conclusions:
- Childhood tuberculosis trends show a concerning increase and a shift towards more severe, adult-like presentations.
- Factors such as malnutrition, adult tuberculosis prevalence, and HIV/AIDS may contribute to these observed trends.
- Public health strategies must address these evolving patterns in pediatric tuberculosis.
Abstract:
In order to determine the trend in childhood tuberculosis, case records of children diagnosed and treated for tuberculosis between January 1981 and December 1995 at the paediatric tuberculosis clinic of the University of Benin Teaching Hospital were reviewed. Of 8,829 paediatric medical cases, 1,026 (11.6%) were managed as tuberculosis. The proportion of tuberculosis cases increased steadily over the study period from 6.9% in 1981 to 22.1% in 1995. An apparent decrease in the number of cases in 1985 (6.6%) was attributable to a strike by medical personnel. The clinical pattern of tuberculosis during the study period shifted toward the adult type with disseminated and cavitating lesions predominating in later years. Additionally, the severity of the disease increased with the incidence of both haemoptysis and finger clubbing increasing from 1.6% in 1981 to 14.2% and 18.2%, respectively, in 1995. Possible reasons for these findings include increased prevalence of malnutrition in childhood, increasing tuberculosis in the adult population and the effects of HIV/AIDS.
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