1. Authors: Chepchieng DB1, Munyua MM2, Ngatia R2
ACTIVE CASE FINDING FOR TUBERCULOSIS AMONG MALNOURISHED CHILDREN BELOW FIVE YEARS OLD: MERU TEACHING AND REFERRAL HOSPITAL EXPERIENCE
Authors: Chepchieng DB1, Munyua MM2, Ngatia R2
1Centre for Health Solutions – Kenya, 2Meru County Teaching and Referral Hospital – Meru
BACKGROUND
Kenya is among the 30 countries in the world with high burden of TB, TB/HIV and MDR-TB and is among the top five from sub Saharan Africa. However TB active case finding is not routinelydone in Integrated Management of Childhood Illnesses (IMCI) Clinics
METHODOLOGY
Meru County hospital adapted the use of a simple TB screening tool (shown on the right) for use in IMCI clinic. The symptom based screening tool was adapted from the national guidelines for management of TB in children. Hospital management and clinic staffs were sensitized on the simplified algorithm for diagnosis of TB in children and all the children seen at the clinic were screened using the above questions. Data from the screening tools were then summarized in Excel spreadsheets and analysis done
TB SCREENING TOOL
CONCLUSION/RECOMMENDATIONS
This is a simple and cost effective tool that can be adopted for use in all levels of health care, including lower level facilities where there are no pediatricians or advanced diagnostic services for TB diagnosis in children. The use of a clinical diagnosis enabled detection of TB in children aged less than 5 years which is a category often missed for TB. Further capacity development of health care workers to obtain sputum specimens for Xpert from children is a gap to be addressed
RESULTS
950 children were screened for Childhood TB between March and December (52%) out of 98 children with presumed TB were diagnosed with TB based on the simplified screening tool. 32 children had X ray done which was suggestive of TB. However none of the children had sputum sample collected for bacteriological tests