This week we would like to share a case of paediatric malnutrition associated with tuberculosis (TB). This 10 month old girl was admitted to Kivunge with cough, fever and failure to gain weight. However on further questioning we saw that she had been treated almost every month since birth with antibiotics for cough and fever, and had never been growing well. Despite all of these courses of antibiotics, her cough and fever never improved. We therefore completed screening for TB and started her (and her mother) on treatment. With this treatment and supplements for malnutrition, we hope that she will begin to gain weight and recover from her chronic infection.
Since January 2019, we have had 4 new cases of TB associated with paediatric malnutrition in Kivunge Hospital. This high prevalence in only one month is because we are now screening every single child with malnutrition for TB.
TB is caused by bacteria that most often affect the lungs, and is curable and preventable. According to WHO, one million children (0–14 years of age) fell ill with TB, and 230,000 children (including children with HIV associated TB) died from the disease in 2017.
Malnutrition has a high risk of death associated with infectious diseases like diarrhoea, malaria, HIV and TB. This is why we are working to screen for HIV, TB and malaria in all malnourished paediatric patients admitted in our Nutrition Clinic.
Malnutrition and TB together create a vicious cycle for the affected child. Malnutrition can lead to secondary immunodeficiency that increases the host's susceptibility to infections, such as TB. TB then leads to reduction in appetite, nutrient absorption and altered metabolism leading to further wasting.
We are continuing to work with and train local staff to treat and prevent many medical complications associated with malnutrition.