Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Abstract

for the African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a retrospective record review of data from 25 hospitals in the

Children and adolescents in African countries should also be vaccinated for COVID-19

“…The AFREhealth study provides multicountry, multiregional evidence of relatively high mortality rates among hospitalised children with COVID-19. Mortality in the AFREhealth study was 8.3%,26 severalfold higher than paediatric case fatality rates of 0.24% (in low and middle-income countries) and 0.01% (in high-income countries) reported in a systematic review by Kitano et al ,10 and still higher than the global average of 0.1%–0.4% reported by the WHO 8…”

“…Among the children who died were 22 (32%) of the 69 children admitted to the intensive care unit (ICU), and 4 (22%) of the 18 with suspected/confirmed MIS-C. 26 In multivariable ordinal logistic regression, factors independently associated with severe outcomes (oxygen requirement, ICU admission, mechanical ventilation and death) were age <1 year, hypertension, chronic lung disease and haematological disorders. 26 …”

“…Thus, high-risk children in African countries should be prioritised for COVID-19 vaccination regardless of their age; this population includes children with hypertension, chronic lung disease and haematological disorders, as reported by the AFREhealth study. 26 Paediatric COVID-19 vaccination can be prioritized using risk stratifications according to presence and number of comorbidities, and cohabitation or close contact with high-risk adults. Likewise, healthy adults living with and/or caring for high-risk children should also be encouraged to get vaccinated; this includes healthcare workers.…”

“…The African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents recently published results of a retrospective study conducted in six African countries. This study included 469 children and adolescents aged 3 months to 19 years hospitalised between March and December 2020 in East (Kenya, Uganda), West (Ghana, Nigeria), Central (Democratic Republic of the Congo) and Southern Africa (South Africa) 26. Approximately 25% of children presented with comorbidities; 3.8% were suspected or confirmed to have MIS-C, and 39 (8.3%) died in hospital.…”

International comparison of the impact of the pandemic and vaccination measures adopted on children and adolescent population

“…1 The child population so far is the least affected by the pandemic in terms of severity (ICU admissions) and mortality. 2 There is some certainty that minors are contagious and can infect the rest of the population, but in general they are not usually carriers of significant viral loads. 3 Faced with this situation, countries have adopted variable attitudes and measures in relation to immunization of children.…”