TB: When newborn cuddles turn deadly

For Mrs Titilayo Babalola, the news was terrifying. She had just been told that Esther, her two-month-old baby, had tuberculosis (TB).

Esther had been sick at birth, which delayed her Bacillus Calmette-Guérin (BCG) vaccination until two weeks later, after she had fully recovered. What began as fever, coughing, and catarrh soon became every mother’s nightmare.

“When they told me my baby had TB, I was scared. I didn’t even know if it was curable. Nobody in my family has TB. How can a two-month-old baby have TB? Nothing like this happened to her older siblings,” Mrs. Babalola said.

Mrs Babalola, a patent medicine vendor based in Ibadan, first took Esther to a nearby primary health care centre. Tests revealed that the baby’s white blood cell count was high, prompting a referral to Oni and Sons Children Hospital.

At the hospital, Esther was admitted for seven days. After a chest X-ray, doctors informed the family that the baby had TB and referred them to Jericho Chest Hospital. Mrs Babalola was reassured that TB is curable and that treatment would be provided free of charge.

Today, Esther is about 5 years old and fully recovered. She no longer coughs and has begun crawling. Tests carried out on her father and siblings showed that none of them had TB.

Looking back, Mrs Babalola suspects that her baby may have contracted TB shortly after birth, when visitors frequently held her. At the time, Esther had not yet received her BCG vaccination, which would have offered some protection.

In many African homes, newborn visits are culturally expected. The common practice involves people gathering in the house to welcome the new baby. However, experts warn that such close contact can expose infants, whose immune systems are still weak, to dangerous infections, including tuberculosis.

Mr Leke Adenora understands this challenge well. He recounted, “My wife usually keeps visitors away from the baby’s room, saying the baby is asleep. In Africa, it’s very difficult to tell visitors not to hold a newborn, even when you don’t know their health status.”

However, Mrs Adebimpe Akanji, a nurse, explained, “We always advise mothers to ensure their babies receive the BCG injection immediately after birth. You don’t know who may be coughing or carrying infections. Someone with TB who is coughing can infect between 15 and 20 people in a year. Newborns are extremely vulnerable because their immunity is still low.”

Tuberculosis claimed 1.23 million lives in Nigeria, other countries in 2024 — WHO

Contrary to popular belief, children can and do contract TB. In Oyo State alone, 589 children were diagnosed with TB in 2022, according to Mrs Abimbola Oyebamiji, a staff member of the Oyo State Ministry of Health, during a four-day review and planning meeting of the USAID-supported Breakthrough Action Nigeria programme in Ibadan.

She explained that symptoms of TB in children include persistent cough, night sweats, loss of appetite, weight loss, and failure to thrive.

“Many children have died because parents never suspected TB. No child should die from TB because diagnosis and treatment are free. Children can get TB from parents, relatives, social gatherings, playgrounds, crèches, and day-care centres. Once parents notice symptoms, they should seek medical help immediately,” she said.

Dr Fatai Tailatu, Principal Medical Officer at Jericho Chest Hospital, confirmed that children contract TB the same way adults do, by inhaling TB germs from someone with the disease who is coughing.

He clarified that while the BCG vaccine may not completely prevent TB infection, it significantly reduces the severity of the disease.

According to him, what we teach parents is good nutrition and vaccination; a well-nourished child who receives BCG has a much lower risk of developing severe TB.

He also addressed widespread misconceptions, stressing that TB is not caused by witchcraft, it cannot be cured with herbal remedies or rituals, and it does not affect only the poor.

According to Dr Tailatu, Jericho Chest Hospital has existed for over 60 years; TB has always been curable with medicine, and treatment has always been free. We have treated countless patients, children included.”

Medical studies further show that when administered at birth, the BCG vaccine can protect newborns against not only TB but also other common infections such as upper respiratory tract infections, chest infections, and diarrhoea, saving thousands of lives each year.

Esther’s story is a reminder that TB is real, preventable, and curable, and that early vaccination and vigilance can mean the difference between life and death for a child.

Here are clear, practical steps to protect children from contracting TB.

 Ensure early BCG vaccination at birth or as early as possible. While BCG may not completely prevent TB infection, it protects children from severe and life-threatening forms of the disease.

• Limit newborn exposure to visitors; avoid allowing many people to hold or closely interact with newborns, especially in the first few weeks of life.

• Keep babies away from anyone who is coughing or appears unwell.

• Screen household members. If anyone in the home has a persistent cough, night sweats, weight loss, or fever, they should be tested for TB immediately.

• Practise good ventilation. Ensure homes, classrooms, and childcare centres are well-ventilated by opening windows and doors regularly.

• Feed children a balanced and nutritious diet to strengthen their immune systems. Malnourished children are more vulnerable to TB infection.

•  Follow up on missed vaccinations.  If a child missed BCG at birth due to illness or other reasons, ensure it is taken as soon as it is medically safe.