How poor diagnosis, non-treatment of infected children fuel tuberculosis spread among peers –Experts

Angela Onwuzoo

The National Coordinator, National Tuberculosis, Leprosy and Buruli Ulcer Control Programme, Dr. Chukwuma Anyaike, has given reasons why tuberculosis is increasing among children in Nigeria.

According to Anyaike, poor diagnosis and failure of parents to release their children for treatment are some of the major factors contributing to the burden of children with tuberculosis in the country.

Anyaike disclosed this during an exclusive interview with PUNCH HealthWise, noting that poor health-seeking behaviour of parents was also adding to the burden.

He revealed that awareness about tuberculosis in Nigeria is just 27 per cent, even as the country remains first in Africa and sixth in the world among countries with the highest TB burden.

The public health physician also identified poor nutrition as a factor contributing to the TB spread.

He explained, “We are having high cases of tuberculosis in children because the diagnosis is difficult. But we are working towards it.

“The burden is very high in children because there is a poor diagnostic platform for children.

“Most parents don’t release their children for treatment and some do not keep to appointment.

“People tend to neglect them, which is not good. The major problem we have is diagnosis. Awareness is just 27 per cent because people think we don’t have TB again.”

According to Anyaike, TB is one of the re-emerging diseases now because there is a high index of poor nutrition.

“There is an incidence of HIV. TB is one of the diseases that kill people with HIV, including children. So, that is the problem we have.

“More embarrassingly, Drug-Resistant TB is on the increase in the country. So, Nigeria is seriously in a very difficult situation in terms of the burden of TB”, he said.

Giving insight into the challenges of diagnosing TB in children, Anyaike said sometimes, it is difficult to get X-rays from children being tested for TB.

“So, we are thinking of other ways. Now, we have been able to find out that we can use the stool of children to diagnose tuberculosis.

“You know also that it is difficult to ask a child to cough to bring out sputum. An adult can cough and bring out sputum. But this is difficult for a child.

He urged parents to ignore stigma and release their children suffering from TB for treatment.

According to the World Health Organisation, TB is the world’s top infectious killer-disease today.

“It is airborne and can affect any one of us. Over 5000 women, men and children still die each day from TB. The social and economic impacts are devastating, including poverty, stigma, and discrimination.

“This disease is curable and preventable, yet global actions and investments fall far short of those needed to end the global TB epidemic,” WHO said.

Also speaking with PUNCH HealthWise, a Lagos-based Registered Dietician-Nutritionist, Cynthia Onyekwere, said some of the risk factors for tuberculosis among children are protein-energy malnutrition and micronutrients deficiencies.

Onyekwere explained, “When a child’s diet is lacking in energy, protein and essential micronutrients, over time it leads to a compromised immune system which in turn increases his or her chances of coming down with infectious diseases, such as tuberculosis.

“Lack of nutritional knowledge, poor complementary feeding practices, low socioeconomic status – to mention but a few – are some of the causes of protein-energy malnutrition and micronutrient deficiencies amongst children.

“On the other hand, when a child has tuberculosis, there is decreased appetite, increased depletion of protein and energy stores(which further leads to muscle wasting), malabsorption of energy-giving nutrients as well as micronutrients.

“All these further worsen a child’s nutritional status and consequently delays recovery from illness.”

The dietitian, therefore, noted that it is important to ensure good nutritional status among children to prevent the occurrence of tuberculosis and to reduce its impact in the eventuality that it occurs.

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