An Assessment of Childhood Tuberculosis Detection in Public Sector Health Facilities in Zimbabwe

Abstract

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. Conclusion: TB screening and diagnostic testing for children below 5 years was very low. There is need to screen all children presenting to primary level facilities.