Background Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a leading cause of infection-related deaths
worldwide. Children with underdeveloped immune systems are particularly vulnerable, experiencing symptoms akin
to common childhood illnesses. Early diagnosis and treatment typically yield positive outcomes. In Nigeria, childhood TB is underreported, complicating accurate burden assessment. This review synthesises and presents evidence
on the disease prevalence among children in Nigeria, identifies clinical characteristics, and evaluates the effectiveness
of treatment regimens and outcomes.
Methodology A comprehensive systematic search across electronic databases was conducted to retrieve studies
on the prevalence, characteristics, diagnostic criteria, and treatment outcomes of childhood tuberculosis in Nigeria. Study registration, data extraction and quality assessment followed standardized guidelines. The meta-analysis
used a random-effects model to determine prevalence and mean treatment outcomes. Statistical heterogeneity
was assessed using the I² statistic, and publication bias was evaluated with Egger’s test (p=0.127) and a funnel plot.
Results This review and meta-analysis of 22 studies, primarily retrospective (77%) and cross-sectional (18.20%),
involving 1,162,936 participants aged 0–18 years, found a pooled prevalence of 20.82% (95% CI: 8.55–36.64)) with high
heterogeneity (I2=99.88%). Pulmonary tuberculosis is the most common form in children 62.70% (95%: 43.57–80.03)
diagnosed using sputum smear microscopy, GeneXpert MTB/RIF assays, chest radiographs, and tuberculin skin tests.
Clinical diagnosis based on symptoms, contact history, and radiological findings is crucial for younger children unable
to produce sputum, as laboratory tests confirm only 6% of cases. Treatment involves the use of rifampicin, isoniazid, pyrazinamide, and ethambutol per national and international guidelines. The meta-analysis showed an average
treatment success rate of 75.47%%, but challenges such as loss to follow-up (11.40%)) and increasing mortality rates
(6.76%) persist.