Challenges to paediatric tuberculosis care as perceived by health workers in Kano, North-western Nigeria

Published: June 30, 2022
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Tuberculosis (TB) remains the world’s deadliest infectious disease that affects a third of the world’s population and newly infected an estimated 10 million people in 2018. The number of TB infected Nigerians ranks sixth in the world and first in Africa. Kano State has the highest Nigerian TB prevalence. I aimed to identify Paediatric TB care challenges as perceived by Kano Medical and DOT health care providers. The study design was prospective, descriptive and cross sectional involving structured questionnaire interviews of 43 healthcare providers, during TB supervision visits of 10 Health facilities in Kano. Generated data was entered, validated and analysed using the STATA 13 statistical software package. The sample size was convenient, since it is the number of all the health providers working in the facilities assigned to the author for supervision under a supervision contract with KNCV in 2017. Of the 43 respondents, there were 26 males, with a M: F ratio of 1.5: 1. Those health workers aged from 30 and 40 years constituted 58% of respondents. The staff cadre of respondents comprised of Community Health Extension Workers [CHEW] (40%), doctors (30%) and nurses (3%). Up to 51% of respondents had over 10 years health worker experience and greater than 36 months Child TB DOT care provision. The most commonly identified challenges to paediatric TB care included poor health knowledge (97.7%), poor health seeking behaviour (95.4%), poverty (95.4%), the inability of children to cough up sputum 95.4%, late presentation (90.7%), contact tracing logistics (90.7 %), patient and community factors of stigma and discrimination (86%) and poor health worker paediatric TB knowledge (70%). Perceived health worker challenges to effective Paediatric TB care were the adult orientation of the TB programme and its contact tracing logistic challenges, inadequate health worker Paediatric TB knowledge, children’s inability to cough up sputum, poverty, poor patient TB health knowledge, community stigma and discrimination, poor health seeking behaviour and late presentation.

World Health Organisation. Global Tuberculosis Report 2021. Geneva. Switzerland. 2021:E1-57.

Chakaya J, Khan M, Ntoumi F, et al. Global Tuberculosis Report 2020 – Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis 2021;113:S7-S12. DOI:

World Health Organisation. Global Tuberculosis Report 2019. World Health Organisation. Geneva. Switzerland; 2019.

Adamu AL, Aliyu MH, Galadanci NA, et al. Deaths during tuberculosis treatment among paediatric patients in a large tertiary hospital in Nigeria. PLoS One 2017; 12:e0183270. DOI:

Nkereuwem E, Kampmann B, Togun T. The need to prioritise childhood tuberculosis case detection. Comment. Lancet 2021; 397:1248-9. DOI:

Sullivan BJ, Esmaili BE, Cunningham CK. Barriers to initiating tuberculosis treatment in sub-Saharan Africa: a systematic review focussed on children and youth. Glob Health Action 2017; 10:1290317. DOI:

Jakhar S, Lenz K, Mukundan H. Current status of pediatric tuberculosis diagnostics, needs and challenges. In: Beckler M. ed., Diagnosis and Management of Tuberculosis. Hayle Medical. 2019;1-13.

Thomas TA. Tuberculosis in Children. Ped Clinics 2017; 64:893-909. DOI:

Atherton RR, Cresswell FV, Ellis J, et al. Xpert MTB/RIF Ultra for Tuberculosis testing in children: A mini review and commentary. Front Pediatr 2019; 7:34. DOI:

Ogbuabor DC, Onwujekwe OE. Governance of tuberculosis control programme in Nigeria. Infect Dis Poverty 2019; 8:45. DOI:

Laghari M, Sulaiman SAS, Khan AH, et al. Contact screening and risk factors for TB among the household contact of children with active TB: a way to find source case and new TB cases. BMC Public Health 2019; 19:1274. DOI:

National Tuberculosis, Leprosy and Buruli Ulcer Control Programme. National Tuberculosis, Leprosy and Buruli Ulcer Control Programme. Worker’s Manual – 6th Edition. Federal Ministry of Health. 2015 Abuja, Nigeria. Available from: Access date 25-11-2021

Ndakidemi E, Emerson C, Medley A et al. Health care worker perspectives on TB case finding and HIV services among pediatric TB patients in Tanzania. Int J Tuberc Lung Dis 2019; 23:811-6. DOI:

Umar, LW & Onyekachi, CA. (2019). Benchmarking childhood tuberculosis control: a re-assessment of Nigeria’s childhood TB control efforts. National Tuberculosis, Leprosy and Buruli Ulcer Control Programme. Available from - Http:'s_Childhood_TB_Control_Efforts. Access date 09/03/2022.

Shimeles E, Tilahun M, Hailu T, et al. Time interval for diagnosis of TB and related expenditure in selected health centres in Addis Ababa, Ethiopia. Hindawi Adv in Pub Health 2019; 2019:4705139. DOI:

Asres A, Jerene D, Deressa W. Pre- and post-diagnosis costs of tuberculosis to patients on Directly Observed Treatment Short course in districts of southwestern Ethiopia: a longitudinal study. J Health Popul Nutr 2018; 37:15. DOI:

Kirubi B, Ong'ang'o J, Nguhiu P et al. Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya. Infect Dis Poverty 2021; 10:95. DOI:

Ogbudebe CL, Adepoju V, Ekerete-Udofia C, et al. Childhood Tuberculosis in Nigeria: Disease Presentation and Treatment Outcomes. Health Serv Insights 2018; 11:1178632918757490. DOI:

Duko B, Bedaso A, Ayano G et al. Perceived stigma and associated factors among patients with Tuberculosis, Wolaita Sodo, Ethiopia: Cross-Sectional Study. Tuberc Res Treat 2019;2019:5917537. DOI:

Kastien-Hilka T, Rosenkranz B, Schwenkglenks M et al. Association between Health-Related Quality of Life and Medication Adherence in Pulmonary Tuberculosis in South Africa. Front Pharmacol 2017; 8:919. DOI:

Alao MA, Maroushek SR and Chan YH et al. Treatment outcomes of Nigerian patients with tuberculosis: A retrospective 25-year review in a regional medical center. PLoS One 2020; 15:e0239225. DOI:

Awoke N, Dulo B, Wudneh F. Total delay in treatment of Tuberculosis and associated factors among new pulmonary TB patients in selected health facilities of Gedeo zone, Southern Ethiopia. Interdiscip Perspect Infect Dis 2019; 2019:2154240. DOI:

Hassan-Hanga, Fatimah. 2022. “Challenges to Paediatric Tuberculosis Care As Perceived by Health Workers in Kano, North-Western Nigeria”. Annals of African Medical Research 5 (1).


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