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Management of paediatric tuberculosis in provincial and district hospitals in Afghanistan

F M Delawer, M Isono, H Ueki

    Eastern Mediterranean Health Journal = La Revue De Sante De La Mediterranee Orientale = Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit
    |July 1, 2014
    PubMed

    Insights

    Diagnosing and treating childhood tuberculosis (TB) in Afghanistan faces significant challenges. Improvements are needed in TB case detection, diagnosis, and contact management within the national TB program.

    Area of Science:

    • Pediatric Infectious Diseases
    • Public Health
    • Global Health

    Background:

    • Childhood tuberculosis (TB) diagnosis and management present global challenges.
    • Afghanistan's national TB program aims to improve pediatric TB care, including contact tracing.
    • Limited data exists on the effectiveness of current pediatric TB case management strategies in Afghanistan.

    Purpose of the Study:

    • To evaluate the current state of pediatric TB case management in Afghanistan.
    • To identify key challenges in diagnosis, treatment, and contact investigation for childhood TB.
    • To provide recommendations for enhancing the national TB program's approach to pediatric TB.

    Main Methods:

    • A retrospective review of pediatric TB case management documents was conducted.
    • Data was collected from 15 district hospitals and 8 provincial hospitals across 7 regions of Afghanistan.
    • Key performance indicators included suspect rates, diagnostic test utilization, treatment adherence, and contact management coverage.

    Main Results:

    • A low outpatient suspect rate of 0.4% was observed, particularly low in children under 5 years.
    • Suspect management yielded low performance, with only 68.5% of suspects receiving further examinations.
    • Low utilization of diagnostic methods, a high early defaulter rate (14.0%), and insufficient contact management coverage (74.0%) were noted.

    Conclusions:

    • Afghanistan's national TB program requires strategic planning to improve pediatric TB diagnosis quality.
    • Enhancing suspect management and diagnostic test utilization is crucial for effective childhood TB case finding.
    • Improving contact management coverage is essential to curb TB transmission in pediatric populations.

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