Although treatable, diagnosing TB in young children is particularly challenging, since it can be very difficult for them to produce sputum (mucus expelled from the respiratory tract)— the traditional way of diagnosing TB in the lungs, known as pulmonary TB. In addition, TB in children can be located outside the lungs—a condition known as extrapulmonary TB, which makes getting samples and accurate diagnostic results even more challenging.
Malnutrition increases the risk of TB
When children are undernourished, their immune systems are compromised, putting them at heightened risk of developing TB. Malnutrition is a problem countrywide in Sierra Leone, making it even more important to be alert to the signs of TB in children.
“I left my village and brought my son here because he was not getting better,” said Aruna, father of three-year-old Augustine. “He was losing weight and coughing a lot. He sweats throughout the night—I have to get up and wipe his sweat away. He is my youngest child; I am scared to see him like this.”
Augustine was diagnosed with TB at the Makeni Regional Hospital in Sierra Leone’s Bombali district, which is supported by MSF. Alongside TB treatment, he is being fed specially formulated therapeutic milk to treat severe malnutrition. “Since he was admitted, the nurses have only been feeding him milk,” said Aruna.
“We treated a three-year-old patient for TB but, after completing her treatment, her mother brought her back because she had TB symptoms again," said MSF nurse Umu Amara, who works at Makeni Hospital. "We did a stool test for the child and the results were still negative for TB. Because she showed all the signs of TB and she was living with HIV, we did the urine test, and the results showed she had TB."
As with Augustine, an alarming number of children under five being treated for TB are found to be severely malnourished. MSF’s team in Bombali district also provides malnutrition treatment as part of its pediatric TB program.
