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Background: Children have been relatively spared from the direct effects of COVID-19 globally, but there are significant concerns about indirect effects on the most vulnerable children's well-being. Nigeria is the largest African nation, but little is known about children's experience of the COVID-19 pandemic. Our aims were to determine children's knowledge of COVID-19 and their mental health responses to the pandemic., Methods: Children aged 6-17 years living in Calabar, Nigeria, were surveyed using a combination of online data collection assisted by parents and on-site data collection at schools. Parents filled out sociodemographic details, while children answered questions about COVID-19 knowledge and preventive measures. An adapted version of the 'Perceived Stress Scale for Children' was used to assess stress with additional free text space for expression of views and experiences of COVID-19., Results: A total of 265 children completed questionnaires, mean age was 12.5 years, 52.1% were girls. All children knew about the virus and over two-thirds (67.8%) had good knowledge of COVID-19 transmission. Children identified television (60.8%), parents (44.2%) and social media (32.8%), as main sources of COVID-19 information. The overall mean stress score among the children was 20.47. Children mentioned the following as stressors: fear of the COVID-19 disease, effect of pandemic restrictions on schooling and social interactions as well as home/family tensions. Parental love and support were overwhelmingly reported as strengths., Conclusions: Nigerian children in this study had good knowledge and understanding of the COVID-19 pandemic and preventive measures to counter the virus. Children had high stress levels and expressed pandemic-related concerns but parental love and support were mitigating factors. Government and child health service providers need to tailor health and support services in response to children's needs and concerns., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The COVID-19 pandemic has disproportionately affected vulnerable children and youth. In Japan, despite evidence that the paediatric age group holds a lower risk of infection than the older population, there was a nationwide closure of schools as an early public health measure. Acknowledging that school closures brought heightened psychological and physical stress among Japanese children, we aimed to explore vulnerable children's experiences of the COVID-19 pandemic in Japan, focusing on socially disadvantaged subset of the population., Methods: We used an adapted version of the 'Perceived Stress Scale for Children', with additional free-text space, delivered online to children attending three non-profit organisations which provide support for this group of vulnerable persons and families experiencing social disadvantage. Simple descriptive analysis was undertaken on the quantitative data; we used thematic and content analysis for the qualitative data., Results: Thirty-six children participated in the online survey, mean age was 11.3 years, majority (61%) were male. The mean overall stress score (score distribution width: 0-39) was 14.8, with no difference in score distribution by age or gender. Free-text responses obtained revealed a range of stressors and protective factors. Schooling, COVID-19 fears, family tension and pandemic measures were sources of stress; family-in particular, the support of the mother-food, friendship and recreation were sources of comfort. While most responses indicated positive coping mechanisms, some displayed maladaptive behaviours., Conclusions: The children in this cohort had high mean stress scores overall. Responses indicated that they were acutely reactive to COVID-19 as well as pandemic public health measures, and that missing schooling and contact with friends exacerbated their stress. Family was a source of strength as well as stress. A tailored public health response to COVID-19 needs to take into account the concerns voiced by vulnerable child populations be based on equity and child rights., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: India is home to the largest child population in the world. India also has faced a devastating burden of COVID-19 infections. During the first wave of COVID-19, the Indian government's lockdown measures brought loss of livelihoods for millions. We aimed to explore the social, psychological and health impacts of the government's pandemic measures on children and young people (CYP), and their families., Methods: Bal Umang Drishya Sanstha (BUDS) is a non-profit organisation providing child health and welfare services to marginalised urban slum communities in New Delhi, India. As part of formative evaluation of BUDS's COVID-19 pandemic relief efforts, the team conducted a rapid survey of 60 children (10-17 years) and 62 young adults (18-25 years) who were beneficiaries of the relief programme. The team also undertook semi-structured interviews with nine young women attending BUDS's second-chance education programme., Results: Almost all respondents had some understanding of COVID-19 (54 children (90%) and 53 young adults (85%)) and the reasons for public health measures (59 children (98%) and 56 young adults (90%)). Over 80% of girls and 60% of boys experienced financial strains and food shortages. Gender discrepancies were particularly evident in areas of family stress, with girls and young women disproportionately experiencing distress and family violence. Girls were more likely to be fearful of contracting the disease, while boys were more concerned about getting back to school. In-depth interviews with young women revealed that government ration schemes were insufficient to support vulnerable families; there were interesting cultural understandings of and responses to the pandemic. Young women reported high rates of anxiety and distress., Conclusions: The lockdown had a multitude of adverse social, health and psychosocial effects on marginalised CYP, disproportionately affecting girls and young women. A tailored response based on equity and child rights is urgently required to address concerns voiced by CYP., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)