Epidemiology of SARS‐CoV‐2 infection and SARS‐CoV‐2 positive hospital admissions among children in South Africa

Kufa, Tendesayi; Jassat, Waasila; Cohen, Cheryl; Tempia, Stefano; Masha, Maureen; Wolter, Nicole; Walaza, Sibongile; Gottburg, Anne von; Govender, Nelesh P.; Hunt, Gillian; Shonhiwa, Andronica Moipone; Ebonwu, Joy; Ntshoe, Genevie; Maruma, Wellington; Bapela, Poncho; Ndhlovu, Nomathamsanqa; Mathema, Hlengani; Modise, Motshabi; Shuping, Liliwe; Manana, Pinky N.; Moore, David P.; Dangor, Ziyaad; Verwey, Charl; Madhi, Shabir А.; Saloojee, Haroon; Zar, Heather J.; Blumberg, Lucille

doi:10.1111/irv.12916

Cited by 14 publications

(17 citation statements)

References 42 publications

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“…Our findings regarding the relative frequency and severity of COVID-19 in children are consistent with those in the literature, specifically that pediatric SARS-CoV-2 infections are common but largely mild or subclinical . Another study in Nicaragua reported that 37.7% of children younger than 15 years were seropositive for SARS-CoV-2, which is substantially lower than the 49.8% (95% CI, 47.5%-52.1%) we observed in our study.…”

Section: Discussionsupporting

confidence: 90%

“…27 Our findings regarding the relative frequency and severity of COVID-19 in children are consistent with those in the literature, specifically that pediatric SARS-CoV-2 infections are common but largely mild or subclinical. [5][6][7] Another study 32 in Nicaragua reported that 37.7% of children younger than 15 years were seropositive for SARS-CoV-2, which is substantially lower than the 49.8% (95% CI, 47.5%-52.1%) we observed in our study. This rate was, however, consistent with that estimated from a previously published analysis 27 in a household transmission cohort in the same community where 56.7% of participants were infected.…”

Section: Discussioncontrasting

confidence: 78%

“… 1 , 2 Although most pediatric SARS-CoV-2 infections are mild or asymptomatic, severe illness can occur in children, including typical severe respiratory infections and multisystem inflammatory syndrome. 3 , 4 Previous studies 5 , 6 , 7 have suggested that younger children, older adolescents, and children with underlying health conditions more frequently present with symptomatic or severe COVID-19, although less commonly than adults. These groups may also be more likely to have long-lasting postacute sequelae, often referred to as long COVID, although still less likely than adults.…”

Section: Introductionmentioning

confidence: 99%

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Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Kubale

Balmaseda²,

Frutos

et al. 2022

JAMA Netw Open

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IMPORTANCEThe impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated. OBJECTIVETo characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children. DESIGN, SETTING, AND PARTICIPANTS In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits. EXPOSURES Prior COVID-19 infection as confirmed by positive anti-SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection at least 60 days before current COVID-19 infection. MAIN OUTCOMES AND MEASURES Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case. RESULTS This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%]male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections. CONCLUSIONS AND RELEVANCEIn this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Kubale

Balmaseda²,

Frutos

et al. 2022

JAMA Netw Open

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“…In SA, on September 2020, the total laboratory-confirmed COVID-19 cases in South African children were 228 per 100,000 and were lower than the 829 per 100,000 children in the United States. COVID-19 cases in children in SA were higher compared to rates of less than 100 per 100,000 children in Norway and Australia [10]. UNICEF report from 96 countries in 2020 has indicated that children and adolescents less than 20 years have accounted for 21% of the COVID-19 cases and 33% of the 2020 population [27].…”

Section: Covid-19 Distribution In Sa Children and Children From Other...mentioning

confidence: 99%

“…There are few studies conducted on the epidemiology and clinical manifestation of COVID-19 in African children in comparison to continents such as China, Europe, and North America [10,21,29]. The findings of studies from other countries cannot be generalizable to South African children because of the differences in the risk factors predisposing children to COVID-19, mostly the burden of infectious diseases [10].…”

Section: Risk Factors Predisposing South African Children To Covid-19...mentioning

confidence: 99%

A Review on the Prevalence, Risk Factors, and Management of COVID-19 Disease in South African Children in Comparison to the World

Binyane¹,

Mfengwana²

2023

Epidemiological and Clinico-Pathological Factors of COVID-19 in Children

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The first case of coronavirus disease of 2019 (COVID-19) in South Africa (SA) was first reported at the beginning of March 2022, and then further spread from Gauteng, Western Cape, and KwaZulu Natal to the rest of the provinces. It is caused by severe acute respiratory syndrome coronavirus 2. In SA, COVID-19 is less prevalent in children less than 18 years. Only a few studies describe the epidemiology, risk factors, and clinical manifestation of COVID-19 among children in SA in comparison to other countries including China, North America, and Europe. South African children are affected by conditions including poverty, tuberculosis, and human immunodeficiency virus which predispose them to COVID-19. Overcrowding and limited healthcare facilities and resources also complicated the diagnosis and clinical and pharmacological management of COVID-19 in SA. The current review discusses the prevalence, risk factors, and management of COVID-19 in South African children in comparison to other continents in the world.

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Changing Epidemiology of COVID-19 in Children and Adolescents Over Four Successive Epidemic Waves in South Africa, 2020–2022

Chiwandire

Jassat

Groome

et al. 2023

Journal of the Pediatric Infectious Diseases Society

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Background South Africa experienced four waves of SARS-CoV-2 infection, dominated by Wuhan-Hu, Beta, Delta and Omicron (BA.1/BA.2). We describe the trends in SARS-CoV-2 testing, cases, admissions, and deaths among children and adolescents in South Africa over successive waves. Methods We analysed national SARS-CoV-2 testing, case, and admissions data from March 2020 to February 2022 and estimated cumulative rates by age group for each endpoint. Severity in the third versus the fourth wave was assessed using multivariable logistic regression. Results Individuals ≤18 years comprised 35% (21,008,060/60,142,978) of the population but only 12% (424,394/3,593,644) of cases and 6% (26,176/451,753) of admissions. Among individuals ≤18 years, infants had the highest admission (505/100,000) rates. Testing, case and admission rates generally increased successively in the second (Beta) and third (Delta) waves among all age groups. In the fourth (Omicron BA.1/BA.2) wave the case rate dropped among individuals ≥1-year but increased among those <1-year. Weekly admission rates for children <1-year (169/100,000) exceeded rates in adults (124/100,000) in the fourth wave. The odds of severe COVID-19 in all admitted cases were lower in the fourth wave versus the third wave in each age group, but they were twice as high in admitted cases with at least one comorbidity than those without. Conclusions The admission rate for children <5 years was higher in the fourth wave than previous waves, but the overall outcomes were less severe. However, children with at least one comorbidity had increased odds of severe disease, warranting consideration of prioritising this group for vaccination.

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Epidemiology of SARS‐CoV‐2 infection and SARS‐CoV‐2 positive hospital admissions among children in South Africa

Cited by 14 publications

References 42 publications

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

A Review on the Prevalence, Risk Factors, and Management of COVID-19 Disease in South African Children in Comparison to the World

Changing Epidemiology of COVID-19 in Children and Adolescents Over Four Successive Epidemic Waves in South Africa, 2020–2022

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