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dc.contributor.authorNachega, Jean B
dc.contributor.authorSam-Agudu, Nadia A
dc.contributor.authorMachekano, Rhoderick N
dc.contributor.authorRabie, Helena
dc.contributor.authorvan der Zalm, Marieke M
dc.contributor.authorRedfern, Andrew
dc.contributor.authorDramowski, Angela
dc.contributor.authorO'Connell, Natasha
dc.contributor.authorPipo, Michel Tshiasuma
dc.contributor.authorTshilanda, Marc B
dc.contributor.authorByamungu, Liliane Nsuli
dc.contributor.authorMasekela, Refiloe
dc.contributor.authorJeena, Prakash Mohan
dc.contributor.authorPillay, Ashendri
dc.contributor.authorGachuno, Onesmus W
dc.contributor.authorKinuthia, John
dc.contributor.authorIshoso, Daniel Katuashi
dc.contributor.authorAmoako, Emmanuella
dc.contributor.authorAgyare, Elizabeth
dc.contributor.authorAgbeno, Evans K
dc.contributor.authorMartyn-Dickens, Charles
dc.contributor.authorSylverken, Justice
dc.contributor.authorEnimil, Anthony
dc.contributor.authorJibril, Aishatu Mohammed
dc.contributor.authorAbdullahi, Asara M
dc.contributor.authorAmadi, Oma
dc.contributor.authorUmar, Umar Mohammed
dc.contributor.authorSigwadhi, Lovemore Nyasha
dc.contributor.authorHermans, Michel P
dc.contributor.authorOtokoye, John Otshudiema
dc.contributor.authorMbala-Kingebeni, Placide
dc.contributor.authorMuyembe-Tamfum, Jean-Jacques
dc.contributor.authorZumla, Alimuddin
dc.contributor.authorSewankambo, Nelson K
dc.contributor.authorAanyu, Hellen Tukamuhebwa
dc.contributor.authorMusoke, Philippa
dc.contributor.authorSuleman, Fatima
dc.contributor.authorAdejumo, Prisca
dc.contributor.authorNoormahomed, Emilia V
dc.contributor.authorDeckelbaum, Richard J
dc.contributor.authorFowler, Mary Glenn
dc.contributor.authorTshilolo, Léon
dc.contributor.authorSmith, Gerald
dc.contributor.authorMills, Edward J
dc.contributor.authorUmar, Lawal W
dc.contributor.authorSiedner, Mark J
dc.contributor.authorKruger, Mariana
dc.contributor.authorRosenthal, Philip J
dc.contributor.authorMellors, John W
dc.contributor.authorMofenson, Lynne M
dc.date.accessioned2022-01-31T13:55:40Z
dc.date.available2022-01-31T13:55:40Z
dc.date.issued2022-01-19
dc.identifier.urihttp://hdl.handle.net/10713/17816
dc.description.abstractImportance: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. Objective: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. Design, Setting, and Participants: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. Exposures: Age, sex, preexisting comorbidities, and region of residence. Main Outcomes and Measures: An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. Results: Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to 19 years. The presence of hypertension (aOR, 5.91; 95% CI, 1.89-18.50), chronic lung disease (aOR, 2.97; 95% CI, 1.65-5.37), or a hematological disorder (aOR, 3.10; 95% CI, 1.04-9.24) was associated with severe outcomes. Age younger than 1 year (adjusted subdistribution hazard ratio [asHR], 0.48; 95% CI, 0.27-0.87), the presence of 1 comorbidity (asHR, 0.54; 95% CI, 0.40-0.72), and the presence of 2 or more comorbidities (asHR, 0.26; 95% CI, 0.18-0.38) were associated with reduced rates of hospital discharge. Conclusions and Relevance: In this cohort study of children and adolescents hospitalized with COVID-19 in sub-Saharan Africa, high rates of morbidity and mortality were observed among infants and patients with noncommunicable disease comorbidities, suggesting that COVID-19 vaccination and therapeutic interventions are needed for young populations in this region..en_US
dc.description.urihttps://doi.org/10.1001/jamapediatrics.2021.6436en_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Pediatricsen_US
dc.titleAssessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.en_US
dc.typeArticleen_US
dc.identifier.doi10.1001/jamapediatrics.2021.6436
dc.identifier.pmid35044430
dc.source.journaltitleJAMA pediatrics
dc.source.countryUnited States
dc.source.countryUnited States


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