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Rise In TB Infection Rate In Children, Adolescents
Last Tuesday, March 29, 2022, the Federal Government declared a State of Emergency on Childhood Tuberculosis. This was disclosed in Abuja by the Coordinator, National Tuberculosis, Buruli Ulcer and Leprosy Control Programme (NTBLCP), Dr Chukwuma Anyaike, at the bi-weekly meeting of the Federal Ministry of Health (FMOH) on COVID-19 and other infectious diseases in the country.
The declaration of emergency may be sequel to the fact that about six percent of all forms of notified TB cases in 2021 were Children less than 15 years. The effects of TB on children in terms of morbidity and mortality are more than that of adults and the ugly development may not be unconnected with the difference.
According to World Health Organisation (WHO) reports “Nigeria has recorded a 50 percent inacrease in Tuberculosis (TB) notification from 138, 591 TB cases in 2020 to 207,785 TB cases in 2021.
The world body also stated that “Tuberculosis in children is usually primary, paucibacillary, characterised by difficulties in diagnosis of both drug susceptible and resistant TB. This is associated with poor uptake of preventive therapy for those with latent infection, contacts and people living with HIV and AIDS (PLWHA) in most developing countries like Nigeria”.
However, the NTBLCP coordinator said that these disturbing statistics calls for a change in narrative of the country’s child TB scourge, stressing that, there is need for concerted response from stakeholders.
He noted that the management of TB in children was characterised by difficulties due to both peculiarities of children and the disease.
“With detailed clinical assessment and examination of necessary specimen, in addition to strict adherence to the guideline of the national TB control programme, more cases of TB in children can be prevented, diagnosed, treated and reported”, he said.
Chukwuma said “we now have a National Steering Committee for Childhood TB, which will now be the central advisory body of the programme. It consists of representatives from donor partners in the programme and includes vast expertise in TB research, academia and staff of NTBLCP”.
He also noted that the capabilities of pediatricians and medical officers were being built in the country to improve early diagnosis and prompt treatment of childhood TB.
“We are improving clinical diagnosis by introducing digital chest X-Ray machines with Artificial Intelligence (AI). The Global Fund is supporting this with USAID. The drug formula for children has improved,” he said.
Chukwuma said that the programme was also collaborating with the National Primary Health Care Development Agency to improve on BCG immunisation to primarily protect children from TB, Leprosy and even Buruli Ulcer.
The Director-General Nigeria Centre for Disease Control (NCDC), Dr. Ifedayo Adetifa said the agency was working to strengthen sub-national disease surveillance systems in the country.
He noted that outbreak detection needed a system to succesfully identify an epidemic at the earliest possible stage through complete and timely reported data.
Adetifa said that “the agency’s priorities remained testing, testing and testing.
“Currently, we have increased Rapid Diagnosis Test (RDT) due to an ongoing surge testing project in Ekiti, Sokoto, Kebbi, Abia, Kwara, Akwa Ibom, Edo and Ondo States,” he added.
Here in Rivers State, the statistics shows that as at 2019, there were 202 Childhood (0-18years) cases seen over a four-year study period.
According to the report by Balafama Alex – Hart, Nsirimobu Paul and Ugwu Rosemary of University of Port Harcourt Teaching Hospital, Nigeria, published in Journal of Tuberculosis Research stated out of the cases, 109 (53.96%) were males and 93 (46.04%) females. Majority of them were 1-4 years of age. There were 194 (96.04%) new cases, 6 (2.9%) transfer and 2 (0.99%) retreatment cases. One hundred and six had pulmonary TB, 23 had TB adenitis, 10 had TB spine, 3 had TB abdoma and 3 had TB meningitis. TB/HIV co infection rate was 48.45%. One hundred and eight completed treatment, 10 were cured, 22 died, 46 defaulted and 16 were transfered out.
In their conclusion, pulmonary TB was the commonest type of TB found and treatment success rate was just above average.
Tuberculosis is a leading cause of death in young children and the risk of progression from infection to disease is higher in very young ones, especially among those with Human Immuodeficiency Virus (HIV) infection.
Infants become infected when they are exposed to Mycobacterium tuberculosis when exposed in several ways. According to Brenda Tesini, MD, University of Rochester School of Medicine and Dentistry in 2020 said that before birth, infection occurs if the bacteria cross the placenta and infect the fetus. During birth, infection occurs if the newborn breaths in or ingests infected fluid from the birth canal. After birth, infection occurs if the newborn inhaled infected droplets that have been coughed or sneezed into the air by family members or nursery personnel.
About 50% of children born to mothers who have an active tuberculosis infection in their lungs develop the infection during the first year of life unless preventive antibiotics or a vaccine called Bacille Calmette- Guerin (BCG) is given.
Symptoms of TB in newborns include looking ill with fever, reduced energy, difficult breathing or difficult to treat pneumonia. Also, they may have a delay in weight gain or physical growth (failure of thrive). This is because tuberculosis usually affects multiple organs and newborns may also have enlarged liver and spleen.
TB in children can be inactive with no symptoms.When the body no longer keeps the TB bacteria under control, then the child becomes unwell with fever,tiredness, sweating at night time,weight loss,coughing, chest pain and chills. In most cases TB affects the lungs, but it can also affect the lymph glands, brain, kidneys or spine. it is most common for children to have TB that affects multiple parts of the body than it is for adults, and TB is likely to be more serious in children according to reports.
TB can be succesfully treated by taking a full course of antibiotics. A child with TB disease may need to take antibiotics for six months or longer. Sometimes antibiotics used to treat TB can cause side effects but these are less common in children than in adults.
Children with TB rarely die when they receive standard treatment for the disease but 90 percent of children who die from TB worldwide go untreated. Health systems often neglect children with TB because children are less contagious than adults and stopping the spread of TB is priority.
By: Ibinabo Ogolo
It is the idea of God that family should exit. Children form part of the family. God loves family so much that Jesus was born into the family of Joseph.
Everyone’s family is good and important. Children should not look down on their family whether they are rich or poor.
Children should respect and honour their family and foster love among their siblings. They should work together and make peace in the family. They should always stand in the gap. It is good for family members to carry all along since everyone may not be doing well.
The Christianity that children learn is practised in family. Faith-based organisations do a great job in moulding children’s character. Those are the behaviours that children exhibit towards siblings in family.
Every child born in a family is there for a purpose. A baby born into a family is supplying something. It may be joy, wealth and so on. Everyone is important in a family.
Adolescents who have graduated from school but may not be contributing financially can do one or two things at home. You can engage in preparing meals at home while parents are away for a job or business. Contributing in house chores will go a long way to relieve parents of stress after a day’s job.
What do you contribute to your family, especially during holidays both in nuclear and extended family?
The family you were born is constant but friends are temporary. You can decide not to continue in friendship but you cannot cut off your family. No matter how bad you think your family is and you decide to leave home, you must surely return. Your friends can harbour you for a while.
The child’s first identity comes from the family. What the child learns first comes from the family.
Family is the centre of love and care. People have started playing down on marriage because of neglect on basics of family. Marriage starts today and and the next few months, it is threatened. Respect for family plays a crucial role in marriage.
No child grows without parental control and influence. If a child refuses to grow without taking instructions from parents, he may grow up being wild. There are consequences when children do not obey their parents. There are those who want to be rebellious against their parents. They should know that their length of days are tied to their parents.
Your bioligical parents know you more than every other person. There is the wisdom and knowledge your parents have that you do not so it is proper to listen to them before choosing carriers both in academics and job. A young man or woman can choose who to get married to, but a greater role in the choice of who to marry and the marriage proper comes from the parents.
They know what is best for you. No matter how modern trends will influence you and prove it wrong, parent is the key. No one can love you more than your parents because they are your blood.
A lot of parents have been traumatised due to the fact that children they nurtured and trained turned their back on them at older age. Children should not abandon their parents for any reason.
As you grow up, situations may arise in marriage when you decide it is over with your spouse, but no matter the level of provocation with your parents, they will not despise you. Parents will also play a role in that regard. Problem arises in every family but how it is handled matters a lot.
Some children honour their mentors more than their parents. Although there are parents who shy away from their responsibilities. It is important that parents take full responsibility of their children. You cannot bring a child to the planet earth and refuse to perform roles as a parent. But parents may not quantify what they spent from childhood to adolescence. That is a blessing children cannot get from another person.
There are people who have attributed their failure in life to the fact that their parents, especially mothers are witchcraft. It is wrong to feel that your mother is instrumental to your failure in life. The only way to success is hardwork.
Let money not determine the level of love for your parents. Wherever a child goes, family is constant.
Eunice Choko-Kayode
Naturally, when a child is born, it is the role of the father and mother to decide a suitable name for the child. The husband and wife normally discuss and suggest the English or vernacular name of the baby.
But sometimes, when a baby comes into a family, grandparents hearts are usually filled with joy to the extent that they want to answer present, by giving their own names not minding the fact that the biological parents have given theirs.
This happens mostly when the marriage is an inter-tribal one. It also happens even in intra-tribal marriage. Grandparents want equal representation as far as naming a child is concerned. They also have special names as a result of circumstances surrounding the birth of the child.
This is still happening till date.
A lot of people have viewed this in different ways but there is nothing wrong about it. The most important thing is that the child bears as many names as he or she can. But one thing is certain, the child must bear one name in school.
Should circumstance determine a child’s name?
Women who are more emotional are always eager to name their children considering the circumstances surrounding the child’s conception and arrival.
The issue of grandparents naming a child comes up mostly when it is the first of the family.
In naming children by some parents in the olden days, they named their children according to the days in the week in which they were born, like Sunday, Monday, Friday and so on.
You may be shocked to hear that whether a child is given 10 names by parents or grandparents, when he or she grows up, will decide to change. There are several cases where some persons decided to change especially when they feel that the names given by their parents and grandparents do not give them joy. If they are not doing well in life, they may claim that their misfortune is caused by the name their parents.
Competition among children in schools be it primary, (kindergarten) and secondary come in different forms. It can be Mathematics , debate, quiz, spelling bee,competition, from organisations like Cowbell, multi-national companies, faith-based organisations among others.
They are organised mostly for selected intelligent ones, the best among their peers to represent a class, school or group. Prizes are normally set aside for the best as well as consolation prizes for runners-up at the end of each session.
The question is, are children willing to accept defeat when they fail? As parents, guardians, can you encourage your children or wards to accept defeat instead of shouting and comparing them with others who may be performing better either in schools or outside.
Some parents may be blaming their children for not doing well in competitions. They will like to tell their children if others who may perform better have ten heads. Those group of parents blame their children for every failure.
For your children to do better in competition, the parents too must have emotional intelligence. When you continue to blame your children for failure, how intelligent are you?
Some parents always want their children to be in the 1st position and unhappy whenever they secure 2nd position. There were instances where children smashed their trophies because they never got the position they wanted to get and their parents supported them.
Children should be able to accept it whether they win or not. They should be encouraged for every performance. Discourage the issue of “shame, shame, shame, shame”.
A parent says she always tells her children to win even if they will fail. Always give them the mentality that they can win. Children should be given the impression that they can win prizes and laurels in every competition.
Parents should not isolate their children from others in the neighbourhood. Allow them to play with others. Don’t threaten your children that you may not pay their schools fees if they fail. Comparing them with others may encourage or discourage them.
Coming first or getting award as a first class student from the university sometimes does not mean that the person is the best. And if the child does not merit any award in the lower classes, does not mean that he can not merit first class also.
It should be noted that coming first in academic competition may not really mean that the competitor will be the best at work place or business.
Accepting defeat is a way to move higher. Even if a child who competed with others did not come first, there are consolation prizes for runners-up. When you advise the child to accept defeat, you are encouraging her to win in next competition.
Remember all children cannot be on the same knowledge level Their learning abilities defer.
Eunice Choko-Kayode