Bacillus Calmette-Guérin Vaccination Coverage and Pediatric Tuberculosis Trends Among Children Aged 0–5 Years at Buea Regional Hospital, Cameroon: A Retrospective Record Review (2020–2024)

Abstract

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality globally, with sub-Saharan African countries like Cameroon carrying a disproportionate share of the burden. Despite the inclusion of the Bacillus Calmette-Guérin (BCG) vaccine in the national immunization program, the persistence of pediatric TB in the Buea Health District raises concerns about immunization coverage and its relationship with disease burden. Aims: This study assessed the trends in BCG vaccination coverage and TB prevalence in children aged 0–5 years at the Buea Regional Hospital from 2020 to 2024. Method: It was a hospital-based retrospective study carried out from March to June 2025, which involved the exhaustive extraction of data from TB and vaccination registers of 0-5 years old children, maintained at the Buea Regional Hospital. The data were analyzed using frequency distributions and line graphs in SPSS version 27. Result: The study reported 6,174 children aged 0–5 years, of whom 5,686 (92.2%) received BCG vaccination. A total of 172 suspected cases of pediatric TB were recorded, with 42 confirmed diagnoses of TB. TB prevalence increased gradually from 0% in 2020 to 0.23% in 2021 and further to 0.76% in 2022, peaking at 1.04% in 2023, followed by a decline to 0.16% in 2024. BCG vaccination coverage dropped progressively from 99.53% coverage in 2020 to 78.92% coverage in 2021 and 50.12% coverage in 2022 but increased to 98.92% coverage in 2023 and later dropped to 77.15% in 2024. Conclusion: These findings highlight the multi-factorial nature of pediatric TB and the need to strengthen both immunization programs and surveillance systems in high-burden settings.