Children in sub-Saharan Africa hospitalised with Covid-19 dying at a higher rate than others: study

A study has found that children in sub-Saharan Africa hospitalised with Covid-19 are dying at a rate far greater than children in the US and Europe.

The study published in JAMA Paediatrics was conducted in 25 hospitals in SA, the Democratic Republic of the Congo, Ghana, Kenya, Nigeria and Uganda between March and December 2020.

Prof Refiloe Masekela, head of the University of KwaZulu-Natal's paediatrics and child health department, led the study at the university.. 

“We are concerned that among African children admitted to 25 hospitals with Covid-19 between March and December 2020, infants younger than one year had nearly five times the risk of death than adolescents aged 15 to 19,” she said.

“Our study found that children of all ages with comorbidities — including high blood pressure, chronic lung diseases, haematological disorders and cancer — were at higher risk of dying. HIV infection also tended to confer a higher risk of death.”

Lead author of the study Prof Jean Nachega, associate professor of infectious diseases and microbiology and epidemiology at the University of Pittsburgh, said: “Though 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 Omicron variant.

“Vaccines are not yet widely available and paediatric intensive care is not easily accessible.”

The study examined outcomes in 469 children between three months and 19 years old, with the average age being 5.9.

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 from the six African countries that provided data, found that 34.6% of hospitalised children were admitted to an intensive care unit or required supplemental oxygen and 21.2% of those admitted to the ICU required invasive mechanical ventilation.

During the study, 39 — more than 8% — of the children died.This is far higher than rates of between 0.1% and 0.5% reported in high-income countries. 

 “The high morbidity and mortality associated with hospitalised children with Covid-19 in our study challenges the existing understanding of Covid-19 as a mild disease in this population,” said Nachega.

“If a child has a comorbidity, is very young and is in a place where there are limited or no specialist doctors, facilities or equipment for paediatric intensive care, that child faces a real possibility of dying.”

The study recommends an urgent scale-up of Covid-19 vaccination and therapeutic interventions among at-risk eligible children and adolescents in Africa.

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