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Paediatric TB

Estimating the burden of tuberculosis (TB) disease in children is difficult due to the lack of a standard case definition, the difficulty in establishing a definitive diagnosis, and the frequency of extrapulmonary TB in young children. These same features present challenges to the clinician who suspects TB in a paediatric patient. Previous National Tuberculosis and Leprosy Programme (NTLP) guidelines emphasised management of adult TB for control purposes.

These current guidelines have been expanded to include management of TB in children to assist the clinician in evaluating and treating children from birth to 15 years of age with suspected or confirmed TB. Age-specific considerations are included throughout, and a section on children younger than 2 years describes their unique manifestations and high risk for progression to severe forms of TB.

CHILDHOOD TB NOTIFICATIONS 2018

There has been a notable increase of proportion of children under the age 15 year being notified among new and relapse TB cases. In 2018, a total of 10,513 children were notified with TB which is 14% of all cases. Among children (under 15 years) notified: 5,986 (57%) were children under the age of 5, while 2,404 (23%) cases were children between age group of 5 -9 years and 2,123 (20%) were children in the age-group 10 – 14 years. Figure 8 and 9, shows proportional of children among notified TB cases per region and trends for the last four years respectively.

Figure 1: Proportion of Children under 15 years among notified TB cases: 2018 

Figure 2: Trends of children notified with TB: 2015 - 2018

IPT PROVISION TO CHILDREN IN 2018

A total of 4,729 children under age of five years household contact of bacterial confirmed TB cases were provided with IPT. All children younger than 5 years in contact with a bacterial confirmed TB are investigated for TB. Children with signs and symptoms suggestive of active TB are registered and treated with a full anti-TB course. If there are no signs of active TB, the children are put on preventive treatment with isoniazid for six months. The average national uptake is 22% with Pemba at 60% and region with lowest uptake is Katavi at 1%. 

Figure 3: Percentage of Children (aged<5) household contact of bacteriological confirmed TB cases on preventive treatment: 2018