From 3% TO 7% Five-Quarter Trends in Childhood Tuberculosis Notification and Case Finding in Ekiti State, Nigeria

Background: Childhood tuberculosis (TB) remains under-recognized in many settings because children can present with nonspecific symptoms, microbiological confirmation is often difficult, and health systems may rely heavily on passive presentation. Routine TB notification data can provide an important signal of programme performance, but changes in notifications must be interpreted carefully because they may reflect changes in disease burden, case finding, diagnosis, reporting or several factors simultaneously. Objective: To describe five-quarter trends in childhood TB notification in Ekiti State, Nigeria, and to interpret changes in childhood TB notifications and age distribution within the context of documented programme strengthening activities. Methods: This descriptive programme-based analysis used validated Ekiti State DHIS2/HMIS data presented in the September 2026 Childhood TB Update. Data included total TB notifications, childhood TB notifications and the percentage of childhood TB among all notified TB cases for Q2 2025 through Q2 2026. Age-specific childhood TB counts were available for Q1 and Q2 2026. Programme information on training and mentorship, integration of childhood TB screening into primary health care, strengthened contact investigation, improved access to chest X-ray and molecular testing, improved specimen referral, HIV and nutrition collaboration, and LGA monitoring was considered in interpreting the trends. Descriptive counts, proportions and absolute changes were examined. Results: Childhood TB notifications were 7, 4, 16, 9 and 20 cases across Q2 2025, Q3 2025, Q4 2025, Q1 2026 and Q2 2026, respectively. Childhood TB represented 3%, 2%, 6%, 4% and 7% of all notified TB cases in the corresponding quarters. Q2 2026 had both the highest childhood TB count and the highest childhood TB proportion in the five-quarter series. Total TB notifications also reached their highest level in Q2 2026, at 302 cases. From Q1 to Q2 2026, notifications among children aged 0–4 years increased from 4 to 12 cases, while notifications among children aged 5–14 years increased from 5 to 8 cases. Conclusion: The Ekiti notification curve changed substantially over the five quarters, with childhood TB increasing from 3% of all notified TB cases in Q2 2025 to 7% in Q2 2026. The increase occurred alongside documented programme strengthening. The findings are therefore consistent with improved detection being an important possible contributor, although the available data cannot establish causality or distinguish improved case finding from changes in underlying disease incidence. Future monitoring should link notification trends to screening coverage, household contact investigation, diagnostic access, referral completion and preventive treatment outcomes.