Little Akeem is in admission at the University College Hospital (UCH) for multi-drug resistant Tuberculosis. The emaciated two-year-old boy, with a hunch back, contracted the infection from his mummy who stopped her TB medications after she got pregnant. He is unable to walk and the mother carried him on her back to the hospital because he was having difficulty breathing.
Tuberculosis (TB) was declared a global public health emergency in 1993. It is one disease that many people assumed only occur in adults. But children account for a significant proportion of the global burden of TB.
Each year, nearly a million children develop TB and 205,000 die of TB-related causes. More than 80% of childhood TB deaths occur in those under the age of 5. Most of these deaths occur because their disease is undiagnosed as children with TB, particularly infants, usually have symptoms that are not specific for the disease.
Professor Regina Oladokun, an infectious disease expert in Children at the UCH, Ibadan, said contrary to many people’s thinking TB also affects children and about 5 per cent of children in admission in the government teaching hospital may have tuberculosis.
Some of these children had TB alongside conditions like HIV, kidney and heart problems. Malnourished children, sometimes also have underlying TB.
Oladokun, the Vice-chairman, Child TB steering committee in National Tuberculosis and Leprosy Control Programme (NTBLCP) added, “It may just be that the child is ill; so, it takes somebody who had been trained to recognise TB in a child because it may mimic a lot of other illnesses.”
She disclosed: “The signs and symptoms of TB in children may be different from adults. Older children and adult with TB will be coughing out blood and mucus, but this may not be the case in younger children with TB. This is because the way TB affects children is different.
“Just like adults, Mycobacterium tuberculosis, the germ that causes TB infection goes to the lungs and thereafter moves into the lymph nodes, and then spread to other organs of the body like the heart, covering of the brain, spine, liver and stomach. So, when children have TB and they cough, they will not cough up blood.
“In adults, the germ stays in the lung, eating into the organs and its blood vessels. So when adults cough, a lot of blood will come out. Most children have tuberculosis outside the lung, which is called extrapulmonary TB. But tuberculosis outside the lung occurs more in children than in adults.”
Professor Oladokun said children with TB develop hunch back when the spine is affected. Spinal TB is a serious form of TB affecting the backbone and its most common presenting complaint is back pain.
The paediatrician, however, said that the signs and symptoms of TB disease in children include cough, feelings of sickness or weakness, lethargy, and/or reduced playfulness; weight loss or failure to thrive; fever; and/or night sweats.
However, she said there is a need for a high suspicion of TB in sick children since these signs and symptoms are also common to many childhood illnesses due to the challenges of confirming TB in children through laboratory tests.
Although the genexpert test is very sensitive for confirming TB in the sputum of adults, she said that this is not the case for childhood TB. She stated that “due to the type of TB in children, getting sputum for testing is difficult. Also, the amount of Tb bacilli in their sputum is small because TB in children is mostly outside of the lungs.
“What we sometimes do is to pass a tube into the stomach to collect sputum and test it. When children cough, they swallow their sputum. But recently, stools of children suspected to have TB are also sent to the laboratory to be checked to see if they contain TB bacilli and confirm the disease.”
Professor Oladokun, however said the case of a child with TB is a telltale sign that TB is inside that community because it is the adults that have TB that are giving it to other adults and the children around.
She added, “there is a lot of bacilli in the lung of an adult with TB. When they cough, they cough out a lot of bacilli into the environment. So anybody that is in an overcrowded place can get the TB; anybody that is living inside the same house as somebody that has TB can also contract it.”
The paediatrician urged mothers to ensure their children get the BCG vaccine as it will protect them against the severe complications of TB. Also, she said, sick children, should be promptly taken to the hospital.
According to her, “TB is not the only problem that we have in children. If a child is losing weight and the child is not doing so well, such should be brought to the hospital for a checkup. It might be TB that is hiding behind the problem.”
YOU SHOULD NOT MISS THESE HEADLINES FROM NIGERIAN TRIBUNE
Battle For First Bank: The Untold Story
Last week was one of twists and turns for First Bank of Nigeria Limited, the nation’s oldest banking institution. It was a week that saw the bank’s MD sacked and reinstated, as major shareholders struggled for control of the financial powerhouse. SULAIMON OLANREWAJU reports…
#EndSARS Panel: Drama As Witness Presents Video Evidence Of Slain Lekki Protesters
A witness of the Lekki tollgate shooting incident, Miss Sarah Ibrahim has presented video evidence of people injured and killed at the scene to the Lagos State Judicial Panel. Tribune Online reports that…
Truck loaded with live bullets falls, spills contents in Onitsha
Onitsha residents are currently in fear, as a truck fully loaded with cartons of live bullets fell into a ditch and spilled its content all around the street, in the commercial city of Anambra State…
After Two Years, Daddy Freeze Apologises To Bishop Oyedepo
Daddy Freeze whose real name is Ifedayo Olarinde has apologised to Bishop Oyedepo who is the presiding bishop and founder of Living Faith Church aka Winners Chapel…
and then