Children in Sub-Saharan Africa dying of COVID-19 at a higher rate than
others, study finds

Date:
January 19, 2022
Source:
University of Pittsburgh
Summary:
Children in sub-Saharan Africa who are hospitalized with COVID-19
are dying at a rate far greater than children in the U.S. and
Europe, according to a new study.



FULL STORY ========================================================================== Children in sub-Saharan Africa who are hospitalized with COVID-19
are dying at a rate far greater than children in the U.S. and Europe,
according to a new multicenter study published today in JAMA Pediatrics
and led by a University of Pittsburgh infectious diseases epidemiologist.


========================================================================== Among African children admitted to 25 hospitals with COVID-19 between
March and December 2020, infants younger than 1 year had nearly five
times the risk of death than adolescents aged 15 to 19 years. Children
of all ages with comorbidities, including high blood pressure, chronic
lung diseases, hematological disorders and cancer, also were at higher
risk of dying.

"Although our study looked at data from earlier in the pandemic, the
situation hasn't changed much for the children of Africa -- if anything,
it is expected to be worsening with the global emergence of the highly contagious Omicron variant," said lead author Jean B. Nachega, M.D.,
Ph.D., M.P.H., associate professor of infectious diseases and microbiology
and epidemiology at Pitt's Graduate School of Public Health. "Vaccines
are not yet widely available, and pediatric intensive care is not easily accessible." The study examined outcomes in 469 children who ranged
in age from 3 months to 19 years and were hospitalized in one of six
countries: the Democratic Republic of the Congo, Ghana, Kenya, Nigeria,
South Africa and Uganda. A quarter of the children had pre-existing
conditions. Eighteen had confirmed or suspected multisystem inflammatory syndrome, a serious complication of COVID-19 where different parts of
the body become inflamed.

The study, which included investigators across all six of the African
countries that provided data, found that 34.6% of hospitalized children
were admitted to an intensive care unit (ICU) or required supplemental
oxygen, and 21.2% of those admitted to the ICU required invasive
mechanical ventilation. During the time frame studied, 39 -- over 8%
-- of the children died. This compares with rates between 1% and 5%
that have been reported in high-income countries.

"The high morbidity and mortality associated with hospitalized children
with COVID-19 in our study challenge the existing understanding of
COVID-19 as a mild disease in this population," said Nachega, also a
professor extraordinary of medicine at Stellenbosch University's Faculty
of Medicine and Health Sciences in Cape Town, South Africa. "But if a
child has a comorbidity, is very young and is in a place where there are limited or no specialized doctors, facilities or equipment for pediatric intensive care, then that child faces a very real possibility of dying."
"Our findings call for an urgent scale-up of COVID-19 vaccination and therapeutic interventions among at-risk eligible children and adolescents
in Africa," Nachega continued. "They also raise further the acute need
for capacity-building and support for pediatric intensive care in these settings." Nachega noted recent progress on increasing the COVID-19
vaccine supply in Africa but emphasized that those vaccines are not yet
widely available and only about 5% of the continent's population has
been fully vaccinated.

"COVID-19 vaccine hesitancy is a global issue, and Africa is no
exception," he said. "It is imperative that evidence-based public
health campaigns address concerns in accessible, trustworthy ways
so that there is high vaccine uptake as soon as it is available."
Additional investigators of this study are members of the African Forum
for Research and Education in Health COVID-19 Research Collaboration on Children and Adolescents and are listed in the JAMA Pediatrics article.

This research was supported by National Institutes of Health Fogarty International Center grant 1R25TW011217-01.

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========================================================================== Journal Reference:
1. Jean B. Nachega, Nadia A. Sam-Agudu, Rhoderick N. Machekano, et al.

Assessment of Clinical Outcomes Among Children and Adolescents
Hospitalized With COVID-19 in 6 Sub-Saharan African Countries. JAMA
Pediatrics, 2022; DOI: 10.1001/jamapediatrics.2021.6436 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220119121439.htm

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