Tuberculosis In Children: These Surmountable Challenges That Continue To Persist

According to the World Health Organisation, WHO, 78 per cent of children in Cameroon aged 0-14 years were not tested for Tuberculosis in 2020.

Come March 24, 2021, stakeholders around the world will again gather in different fora to raise awareness on the urgency to tackle Tuberculosis or TB. And also mark the International Day for the Fight Against Tuberculosis. An infectious disease that affects all age groups, the good news is that Tuberculosis is treatable. Though this takes quite some time and resources.   

 

Worrying Statistics, Reassurance  

The World Health Organisation, WHO, warns that 78 per cent of Cameroon’s children aged 0-14 years were not tested for TB in 2020. While lower respiratory infections represent 10.12 per cent of deaths – the fourth cause of deaths in children. In 2018, infant mortality rate in Cameroon was 48 per 1,000 live births, according to the 2018 Household Health Survey. Officials say insufficient resources are to blame for the inability to access quality Tuberculosis treatment.

“There are about 186 cases of Tuberculosis in 100,000 inhabitants. In 2020, 22,511 cases of Tuberculosis were reported in Cameroon,” says Dr Mbassa Vincent, Permanent Secretary of the National Committee for the Fight Against Tuberculosis. According to Dr Mbassa, about 5 per cent of TB cases reported over the past years concerned children aged 0-15 years. Meanwhile, the Ministry of Public Health - with the support of partners - has stepped up research on TB in children by providing new diagnostic tools, he assures.

 

Included In Maternal, Infant Healthcare?

Dr Mbassa insists that TB is already included in maternal and infant healthcare services across the country. “For example, midwives are trained to look out for TB in pregnant women. And paediatricians and general practitioners trained to diagnose TB in children. While all newborn are administered anti-Tuberculosis vaccine under the Expanded Programme on Vaccination,” Mbassa explains. 

Ndichia Amos, Tuberculosis Control Coordinator of the Cameroon Baptist Convention Health Board (which runs health facilities in 7 of Cameroon’s 10 regions), agrees with Dr Mbassa. “Managing TB in children is already included in our health facilities. What is lacking is the systematic implementation of the policy,” Ndichia says. He adds that identification of pregnant and breastfeeding women with TB during maternal and child care, for example, could directly influence the disease’s prevention in children. While early diagnosis of children infected with TB could reduce morbidity and mortality.

 

Cost As Hindrance?

“All anti-TB medications are free for all age groups until the completion of treatment. This applies all over the country. However, poor people have more difficulties accessing treatment because certain charges are required such as consultation and tests. The Ministry of Public Health still has to work hard to ease access to TB diagnosis,” Dr Mbassa admits.  

 

Diagnosis, Treatment Hiccups

Diagnosing TB in children remains a challenge worldwide, Ndichia Amos discloses. “This is because TB symptoms mimic other childhood disease symptoms, making it difficult to conclude on diagnoses. Also, children do not cough and expectorate like adults. Gastric-aspirated and other specialized skills are therefore required to make accurate diagnoses,” he asserts.

Meanwhile, the CBC Health Board has put in place measures to actively search for TB in children, especially cases of contact with TB patients. But there is a hitch: “Drugs for treating TB are available, but children's formulation has been out of stock for years now,” Ndichia reveals with regret. 

 

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