Evaluation of Diagnostic Services for Childhood Pneumonia in Secondary Healthcare Facilities in Taraba State

Pneumonia remains the leading infectious cause of death in children under five in Nigeria, and accurate etiological diagnosis is critical to reducing mortality through targeted treatment. This facility-based cross-sectional study evaluated the diagnostic services available and utilized for childhood pneumonia management in six secondary healthcare facilities across Jalingo and Wukari local government areas of Taraba State, in the North East geopolitical zone of Nigeria. An assessment tool covering diagnostic infrastructure, pneumonia case management protocols, laboratory test availability, and clinical outcome data was administered. Medical records of 240 under-five children admitted with WHO-defined severe and very severe pneumonia over a 12-month period in 2023 were reviewed. Chest X-ray services were available in only two of six facilities. Blood culture for bacteriological diagnosis was performed in 9.2 percent of admitted pneumonia cases. Sputum culture was not routinely performed for any age group. Oxygen therapy was available but intermittently supplied in 50 percent of facilities. Case fatality rate for very severe pneumonia was 18.3 percent. These diagnostic and therapeutic gaps indicate severe limitations in pneumonia management capacity in Taraba secondary facilities. Rapid antigen tests for Streptococcus pneumoniae, enhanced X-ray access, oxygen concentrator procurement, and microbiology laboratory strengthening are urgently recommended. Keywords: childhood pneumonia, diagnostic services, Taraba, secondary healthcare, under-five mortality.