Africa Defense Forum
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Study: African Children Hospitalized With COVID-19 At Higher Risk


After two years of COVID-19, the disease severity is substantially lower among children and adolescents, compared with adults, scientific studies have reported.

Not so in Africa.

A new multicountry study in Africa found that young people hospitalized with COVID-19 have a significantly greater chance of long-term illness or death than those elsewhere.

“This study provides important information about COVID-19 among African children that was not previously available at this scale,” co-author Dr. Nadia Sam-Agudu said in a statement. “We now have evidence from multiple countries to show that African children also experience severe COVID-19, they experience multisystem inflammatory syndrome, some require intensive care, and some also die, and at much higher rates than outside Africa.”

The research, a collaboration of cross-disciplinary health personnel by the African Forum for Research and Education in Health (AFREhealth), was conducted on 469 children and adolescents hospitalized with COVID-19 in six Sub-Saharan African countries between March and December 2020.

The study showed a high overall mortality rate of 8.3%, compared with 1% or less reported from Europe and North America.

African children less than a year old with preexisting noncommunicable diseases also were more likely than other children to need intensive care or to die.

Researchers from the Institute of Human Virology Nigeria in Abuja and Ahmadu Bello University in Zaria, Nigeria, published their report in the Journal of the American Medical Association on January 19.

“The AFREhealth study findings show that COVID-19 affects children and can cause severe consequences,” Dr. Ifedayo Adetifa, director-general of the Nigeria Centre for Disease Control, said in a statement. “We seriously need to factor children into age-disaggregated COVID-19 disease surveillance and reporting.

“Furthermore, the high in-hospital mortality rate reported indicates a need for investments in critical care for children in African settings.”

The AFREhealth study collected data on young people ages 3 months to 19 years at 25 health facilities across Nigeria, Ghana, Democratic Republic of the Congo, Kenya, South Africa and Uganda.

Eighteen children had confirmed or suspected multisystem inflammatory syndrome, a serious complication of COVID-19 in which parts of the body become swollen and cause pain. Four participants died.

Of the more than 315 million cases and 5.5 million COVID-19 deaths reported as of early 2022, more than 29 million cases and 22,000 deaths were estimated among children and adolescents ages 0 to 19, according to World Health Organization data.

Lead author of the study, Dr. Jean Nachega, an epidemiologist with Stellenbosch University in South Africa, said rising numbers of cases on the continent are cause for great concern.

“Although our study looked at data from earlier in the pandemic, the situation hasn’t changed much for the children of Africa,” Nachega told Nigerian newspaper Premium Times. “If anything, it is expected to be worsening with the global emergence of the highly contagious omicron variant.”

Nachega said the study highlights a major problem in Africa — that pediatric intensive care is not easily accessible.

Adetifa agreed, saying the study underscores the need for research to lead to significant changes in health care priorities.

“We need more of such rigorous multicenter studies to inform evidence-based policy-making in Nigeria and other African countries,” he said.

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