Children in sub-Saharan Africa dying of Covid-19 at a higher rate than elsewhere

CAPE TOWN- Children in sub-Saharan Africa who are hospitalised with Covid-19 are dying at a rate far greater than children in the US and Europe, according to a new multicentre study published this week.

The study was led by an infectious diseases epidemiologist, Professor Jean Nachega, of the University of Pittsburgh in the US and Stellenbosch University (SU) and was published on Wednesday in Jama Pediatrics.

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 years. Children of all ages with comorbidities, including high blood pressure, chronic lung diseases, haematological disorders and cancer, were also 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 Nachega. “Vaccines are not yet widely available, and paediatric intensive care is not easily accessible.”

The study examined outcomes in 469 children who ranged in age from three months to 19 years and were hospitalised 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 found that 34.6% of hospitalised 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 hospitalised children with Covid-19 in our study challenge the existing understanding of Covid-19 as a mild disease in this population. But if a child has a comorbidity, is very young and is in a place where there are limited or no specialised doctors, facilities or equipment for paediatric intensive care, then that child faces a very real possibility of dying,” said Nachega.

“Our findings call for an urgent scale-up of Covid-19 vaccination and therapeutic interventions among at-risk eligible children and adolescents in Africa. They also raise further the acute need for capacity-building and support for paediatric intensive care in these settings.”

Cape Times