Accessible Requires Authentication Published by De Gruyter April 29, 2021

Addressing gaps in adolescent tuberculosis programming and policy in Nigeria from a public health perspective

Ufuoma Aduh ORCID logo, Atana Uket Ewa, Nadia A. Sam-Agudu ORCID logo, Ochuko Urhioke, Oluremilekun Kusimo, Chukwuebuka Ugwu, Omoniyi A. Fadare and Chukwuma Anyaike

Abstract

Objectives

Tuberculosis (TB) is a leading infectious cause of death globally. Of the estimated 10 million people who developed active TB in 2019, 1.8 million (18%) were adolescents and young adults aged 15–24 years. Adolescents have poorer rates of TB screening, treatment initiation and completion compared to adults. Unfortunately, there is relatively less programme, research and policy focus on TB for adolescents aged 10–19 years. This article reviews the scope of health services and the relevant policy landscape for TB case notification and care/treatment, TB/HIV management, and latent TB infection for adolescents in Nigeria. Additionally, it discusses considerations for TB vaccines in this population.

Content

All Nigeria Federal Ministry of Health policy documents relevant to adolescent health services and TB, and published between 2000 and 2020 underwent narrative review. Findings were reported according to the service areas outlined in the Objectives.

Summary and Outlook

Nine policy documents were identified and reviewed. While multiple policies acknowledge the needs of adolescents in public health and specifically in TB programming, these needs are often not addressed in policy, nor in program integration and implementation. The lack of age-specific epidemiologic and clinical outcomes data for adolescents contributes to these policy gaps. Poor outcomes are driven by factors such as HIV co-infection, lack of youth-friendly health services, and stigma and discrimination. Policy guidelines and innovations should include adaptations tailored to adolescent needs. However, these adaptations cannot be developed without robust epidemiological data on adolescents at risk of, and living with TB. Gaps in TB care integration into primary reproductive, maternal-child health and nutrition services should be addressed across multiple policies, and mechanisms for supervision, and monitoring and evaluation of integration be developed to guide comprehensive implementation. Youth-friendly TB services are recommended to improve access to quality care delivered in a patient-centered approach.


Corresponding author: Dr. Ufuoma Aduh, World Health Organisation, Asaba, Delta State, Nigeria; and Texila American University, Georgetown, Guyana, Phone: +234 8035725786, E-mail:

aMember of Nigeria’s National Childhood Tuberculosis Steering Committee


  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2020-11-23
Accepted: 2021-04-01
Published Online: 2021-04-29

© 2021 Walter de Gruyter GmbH, Berlin/Boston