Scaling Up Childhood TB Case-Finding in Nigeria through External Collaboration and Continuous Learning and Improvement

In 2022, Nigeria faced significant challenges in childhood (tuberculosis) TB diagnosis. Despite achieving a 61% overall TB case finding rate, only 7% of estimated child TB cases were notified, falling short of the World Health Organization's benchmark of 12%. Underdiagnosis among children due to factors like undernutrition, HIV, and low awareness poses a critical issue. Responding to this, Breakthrough ACTION-Nigeria, an eight year cooperative agreement funded by USAID to lead social and behavior change programming around the world and in Nigeria, in collaboration with Nigeria’s National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP) and partners, applied a CLA approach to adapt and scale up the successful National TB Testing Week model for children. This approach leveraged collaboration with partners, a culture of continuous learning, and adaptive management. The first Childhood TB Testing Week in May 2023 targeted areas of high childhood TB prevalence, including schools, nutrition clinics, and orphanages. Motorized vans, integrated services, and other interventions resulted in 331,595 children screened and 9,406 presumptive TB cases identified. 4,054 children were diagnosed and placed on TB treatment, demonstrating the initiative's impact. Building on lessons learned, a second edition in May 2024 expanded to more communities and spread over two weeks. Data from just 18 states, supported through several USAID projects, indicates 3,086 children diagnosed and placed on treatment.* The success was a result of strong and effective partnerships, an adaptive organizational culture fostering a concerted effort towards improving childhood TB diagnosis and treatment in Nigeria. *National level data not yet available.