An Assessment of Childhood Tuberculosis Detection in Public Sector Health Facilities in Zimbabwe
Introduction: Zimbabwe has consistently failed to meet the World Health Organization’s
target of 10 to 15% of Tuberculosis (TB) notifications being children below 15 years,
with the country experiencing a proportionate decline in childhood TB contribution
to national notifications from 9% in 2011 to 5% in 2017.
Methodology: We conducted a descriptive cross-sectional
study in 20 public sector health facilities across 4 districts. We abstracted childhood
TB screening, diagnosis and treatment data from facility registers for the year
2019. Study was approved by local ethics committee and a waiver of consent was obtained
for accessing patient data.
Results: Data for 21,791 children who accessed health services were abstracted,
and 1,116 had documented TB management data. Overall, 3.1% of children were screened
for TB; 0.8% for children below 5 years, 5.2% for ages 5-9, and 7.3% for ages 10-14
years. TB screening was significantly higher in referral (6.9%) than primary level
(1.7%) facilities (p<0.05). About 63.2% of presumptive TB children had TB diagnostic
tests; 51.2% for children below 5 years, 55.8% for ages 5-9 and 71.4% for ages 10-14
years. A majority (71.9%) of tests were conducted on GeneXpert MTB Rif platform
and 17.9% were by microscopy. About 9.3% of tested children were diagnosed with
TB, and 93.5% of these were initiated on treatment. Treatment outcomes for 65% of
eligible children were evaluated.
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