PREVALENCE AND MANAGEMENT OF TUBERCULOSIS IN CHILDREN IN ABIA STATE, NIGERIA

Childhood tuberculosis (TB) remains a neglected aspect of the TB epidemic in Nigeria, with limited sub-national data to guide interventions. This study aimed to determine the prevalence, describe the management practices, and assess treatment outcomes of childhood TB in Abia State, Nigeria. A retrospective cross-sectional study was conducted across 12 selected DOTS centres in Abia State, covering a five-year period from January 2020 to December 2024. Data were extracted from TB treatment registers and patient cards for all children aged 0-14 years diagnosed and treated for TB during this period. A total of 486 childhood TB cases were reviewed. Data on socio-demographics, clinical characteristics, diagnostic methods, and treatment outcomes were analyzed using SPSS version 26, with descriptive statistics and chi-square tests employed. The period prevalence of childhood TB was 8.5% (486 out of 5,712 total TB cases). The majority of children were aged 5-14 years (62.1%), with a male-to-female ratio of 1.2:1. Pulmonary TB accounted for 84.8% of cases, while 15.2% were extrapulmonary, with TB meningitis comprising 24.3% of EPTB cases. Diagnosis was predominantly clinical (57.2%), with bacteriological confirmation via GeneXpert achieved in only 37.9% of cases. HIV co-infection was present in 14.0% of children. The treatment success rate was 81.9%, while 10.7% were lost to follow-up, and 4.9% died. HIV co-infection was significantly associated with unsuccessful treatment outcomes (p = 0.0002), with 35.3% of HIV-positive children experiencing poor outcomes compared to 14.6% of HIV-negative children. Childhood TB is a significant public health concern in Abia State, with a prevalence of 8.5% and a treatment success rate below the WHO target of 90%. The high reliance on clinical diagnosis, significant loss to follow-up, and strong negative impact of HIV co-infection on outcomes are critical challenges. There is an urgent need to strengthen bacteriological diagnosis, enhance contact tracing and Isoniazid Preventive Therapy (IPT) uptake, integrate comprehensive HIV care, and implement interventions to reduce loss to follow-up in order to achieve the End TB goals in Abia State. Keywords: Childhood Tuberculosis, Prevalence, Management, Treatment Outcomes, Abia State, Nigeria.