The report of the mid-term review of the 2010 - 2015 National Strategic Plan for Tuberculosis (TB) in 2013 recommended among other things that the National TB, Leprosy and Buruli Ulcer Control Programme (NTBLCP) should strengthen interventions to improve notification and management of childhood TB cases in the country. The NTBLCP has leveraged on the support from partners to address the observations and recommendations in the report. Consequently, the road map for childhood TB control was developed in 2013. The National Strategic Plan 2015 - 2020 for TB has as its third objective, “Implement new strategies to improve the control of TB in children in line with the global road map for childhood TB”. In line with this objective, a number of strategic interventions have been put in place. These include:
- Training of trainers on childhood TB
- Review of training manual for training of all cadre of health care providers on childhood TB
- Training of health care providers from tertiary and secondary health facilities on childhood TB
- Capacity building on childhood multi-drug resistant TB (MDR-TB) for programme officers and clinicians
- Provision of chest-x-ray support to aid diagnosis of TB in children
- Development and distribution of several copies of childhood TB desk guide to aid health care workers across the country in diagnosing and managing childhood TB
- Ensuring un-interrupted supply of anti-TB drugs for both treatment and prevention of TB in children.
- Introduction of Xpert MTB/RIF assay as the first-line test for diagnosis of TB
- Development of algorithm for the use of Xpert MTB/RIF assay for TB diagnosis in children
- Constitution of a National Childhood TB Steering Committee to provide strategic advice to the NTBLCP with regards to childhood TB control
- Development of work plan for childhood TB
- Improved engagement of paediatricians through participation as well as presentations on childhood TB at paediatric conferences
- Improved engagement of other stakeholders (e.g Federal Ministry of Education and maternal and child health practitioners) in the fight against TB.
- The development and implementation of a road map for introduction of the new child-friendly paediatric drug formulation
- Ongoing development of standard operating procedures/information, education and communication materials on childhood TB
- Ongoing designation of focal points for paediatric TB in tertiary and secondary health facilities.
- Operational researches to improve recording and reporting of childhood TB cases, evaluating the performance of Xpert MTB/RIF assay utilization for TB case finding among children as well as benchmarking of childhood TB control
The annual notification of childhood TB cases (in the past five years) in the country averages 6% of all forms of TB cases notified annually. This represents a marginal improvement over the 3% recorded in 2009. A more worrisome trend that is not in keeping with the epidemiology of TB is the lower notification among under-5 children compared to the 5-14years age group. Adequate knowledge and skills in diagnosing and managing childhood TB (especially in the primary health care settings) still remains a major challenge to childhood TB control. In order to build on the current achievements and intensify childhood TB case finding in Nigeria, the NTBLCP is prioritizing integration of TB care with maternal, newborn and child health services in line with global recommendations. A comprehensive road map is being developed to aid this integration and all relevant stakeholders will be brought on board.