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4. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, and African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents

Abstract

IMPORTANCE: 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

Published
2022

5. Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rosenthal, Philip J, Schell, Sonja, de Waard, Liesl, Bekker, Adrie, Gachuno, Onesmus W, Kinuthia, John, Mwongeli, Nancy, Budhram, Samantha, Vannevel, Valerie, Somapillay, Priya, Prozesky, Hans W, Taljaard, Jantjie, Parker, Arifa, Agyare, Elizabeth, Opoku, Akwasi Baafuor, Makarfi, Aminatu Umar, Abdullahi, Asara M, Adirieje, Chibueze, Ishoso, Daniel Katuashi, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Bongo-Pasi Nswe, Christian, Ditekemena, John, Sigwadhi, Lovemore Nyasha, Nyasulu, Peter S, Hermans, Michel, Sekikubo, Musa, Musoke, Philippa, Nsereko, Christopher, Agbeno, Evans K, Yeboah, Michael Yaw, Umar, Lawal W, Ntakwinja, Mukanire, Mukwege, Denis M, Birindwa, Etienne Kajibwami, Mushamuka, Serge Zigabe, Smith, Emily R, Mills, Edward J, Otshudiema, John Otokoye, Mbala-Kingebeni, Placide, Tamfum, Jean-Jacques Muyembe, Zumla, Alimuddin, Tsegaye, Aster, Mteta, Alfred, Sewankambo, Nelson K, Suleman, Fatima, Adejumo, Prisca, Anderson, Jean R, Noormahomed, Emilia V, Deckelbaum, Richard J, Stringer, Jeffrey S A, Mukalay, Abdon, Taha, Taha E, Fowler, Mary Glenn, Wasserheit, Judith N, Masekela, Refiloe, Mellors, John W, Siedner, Mark J, Myer, Landon, Kengne, Andre-Pascal, Yotebieng, Marcel, Mofenson, Lynne M, Langenegger, Eduard, AFREhealth Research Collaboration on COVID-19 and Pregnancy, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'endocrinologie et de nutrition, Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rosenthal, Philip J, Schell, Sonja, de Waard, Liesl, Bekker, Adrie, Gachuno, Onesmus W, Kinuthia, John, Mwongeli, Nancy, Budhram, Samantha, Vannevel, Valerie, Somapillay, Priya, Prozesky, Hans W, Taljaard, Jantjie, Parker, Arifa, Agyare, Elizabeth, Opoku, Akwasi Baafuor, Makarfi, Aminatu Umar, Abdullahi, Asara M, Adirieje, Chibueze, Ishoso, Daniel Katuashi, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Bongo-Pasi Nswe, Christian, Ditekemena, John, Sigwadhi, Lovemore Nyasha, Nyasulu, Peter S, Hermans, Michel, Sekikubo, Musa, Musoke, Philippa, Nsereko, Christopher, Agbeno, Evans K, Yeboah, Michael Yaw, Umar, Lawal W, Ntakwinja, Mukanire, Mukwege, Denis M, Birindwa, Etienne Kajibwami, Mushamuka, Serge Zigabe, Smith, Emily R, Mills, Edward J, Otshudiema, John Otokoye, Mbala-Kingebeni, Placide, Tamfum, Jean-Jacques Muyembe, Zumla, Alimuddin, Tsegaye, Aster, Mteta, Alfred, Sewankambo, Nelson K, Suleman, Fatima, Adejumo, Prisca, Anderson, Jean R, Noormahomed, Emilia V, Deckelbaum, Richard J, Stringer, Jeffrey S A, Mukalay, Abdon, Taha, Taha E, Fowler, Mary Glenn, Wasserheit, Judith N, Masekela, Refiloe, Mellors, John W, Siedner, Mark J, Myer, Landon, Kengne, Andre-Pascal, Yotebieng, Marcel, Mofenson, Lynne M, Langenegger, Eduard, and AFREhealth Research Collaboration on COVID-19 and Pregnancy

Abstract

BACKGROUND: Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. METHODS: We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models. RESULTS: Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42-4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44-2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08-3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20-3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17-2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79-14.13). CONCLUSIONS: Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women.

Published
2022

6. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Author

Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rabie, Helena, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B, Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Martyn-Dickens, Charles, Sylverken, Justice, Enimil, Anthony, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Sigwadhi, Lovemore Nyasha, Hermans, Michel, Otokoye, John Otshudiema, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Zumla, Alimuddin, Sewankambo, Nelson K, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Suleman, Fatima, Adejumo, Prisca, Noormahomed, Emilia V, Deckelbaum, Richard J, Fowler, Mary Glenn, Tshilolo, Léon, Smith, Gerald, Mills, Edward J, Umar, Lawal W, Siedner, Mark J, Kruger, Mariana, Rosenthal, Philip J, Mellors, John W, Mofenson, Lynne M, African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Centre de pathologie sexuelle masculine, and UCL - (SLuc) Service d'endocrinologie et de nutrition

Subjects
Male, Adolescent, SARS-CoV-2, Pneumonia, Viral, Oxygen Inhalation Therapy, COVID-19, Infant, Length of Stay, Respiration, Artificial, Child, Preschool, Pediatrics, Perinatology and Child Health, Outcome Assessment, Health Care, Humans, Female, Child, Child, Hospitalized, Pandemics, Africa South of the Sahara
Abstract

IMPORTANCE: 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.

Published
2022

8. Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Author

Nachega, Jean B, Sam-Agudu, Nadia A, Machekano, Rhoderick N, Rosenthal, Philip J, Schell, Sonja, Waard, Liesl de, Bekker, Adrie, Gachuno, Onesmus W, Kinuthia, John, Mwongeli, Nancy, Budhram, Samantha, Vannevel, Valerie, Somapillay, Priya, Prozesky, Hans W, Taljaard, Jantjie, Parker, Arifa, Agyare, Elizabeth, Opoku, Akwasi Baafuor, Makarfi, Aminatu Umar, and Abdullahi, Asara M

Subjects
HEALTH policy, REVERSE transcriptase polymerase chain reaction, COVID-19, CONFIDENCE intervals, COVID-19 vaccines, RETROSPECTIVE studies, REGRESSION analysis, CHILDBEARING age, PREGNANT women, SEVERITY of illness index, HOSPITAL mortality, HOSPITAL care, DESCRIPTIVE statistics, OXYGEN therapy, MEDICAL practice, LONGITUDINAL method, PROPORTIONAL hazards models, PREGNANCY
Abstract

Background Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. Methods We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models. Results Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42–4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44–2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08–3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20–3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17–2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79–14.13). Conclusions Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women. [ABSTRACT FROM AUTHOR]

Published
2022
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11. The Critical Need for Pooled Data on COVID-19 in African Children: An AFREhealth Call for Action through Multi-Country Research Collaboration.

Author

UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, Sam-Agudu, Nadia A, Rabie, Helena, Pipo, Michel Tshiasuma, Byamungu, Liliane Nsuli, Masekela, Refiloe, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, Mukalay, Abdon, Gachuno, Onesmus W, Mongweli, Nancy, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Ayele, Birhanu T, Machekano, Rhoderick N, Nyasulu, Peter S, Hermans, Michel, Otshudiema, John Otokoye, Bongo-Pasi Nswe, Christian, Kayembe, Jean-Marie N, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Fowler, Mary Glenn, Sewankambo, Nelson, Suleman, Fatima, Adejumo, Prisca, Tsegaye, Aster, Mteta, Alfred, Noormahomed, Emilia V, Deckelbaum, Richard J, Zumla, Alimuddin, Mavungu Landu, Don Jethro, Tshilolo, Léon, Zigabe, Serge, Goga, Ameena, Mills, Edward J, Umar, Lawal W, Kruger, Mariana, Mofenson, Lynne M, Nachega, Jean B, for investigators in the AFREhealth COVID-19 Research Collaboration on Children and Adolescents, UCL - (SLuc) Service d'endocrinologie et de nutrition, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, Sam-Agudu, Nadia A, Rabie, Helena, Pipo, Michel Tshiasuma, Byamungu, Liliane Nsuli, Masekela, Refiloe, van der Zalm, Marieke M, Redfern, Andrew, Dramowski, Angela, Mukalay, Abdon, Gachuno, Onesmus W, Mongweli, Nancy, Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, Agbeno, Evans K, Jibril, Aishatu Mohammed, Abdullahi, Asara M, Amadi, Oma, Umar, Umar Mohammed, Ayele, Birhanu T, Machekano, Rhoderick N, Nyasulu, Peter S, Hermans, Michel, Otshudiema, John Otokoye, Bongo-Pasi Nswe, Christian, Kayembe, Jean-Marie N, Mbala-Kingebeni, Placide, Muyembe-Tamfum, Jean-Jacques, Aanyu, Hellen Tukamuhebwa, Musoke, Philippa, Fowler, Mary Glenn, Sewankambo, Nelson, Suleman, Fatima, Adejumo, Prisca, Tsegaye, Aster, Mteta, Alfred, Noormahomed, Emilia V, Deckelbaum, Richard J, Zumla, Alimuddin, Mavungu Landu, Don Jethro, Tshilolo, Léon, Zigabe, Serge, Goga, Ameena, Mills, Edward J, Umar, Lawal W, Kruger, Mariana, Mofenson, Lynne M, Nachega, Jean B, and for investigators in the AFREhealth COVID-19 Research Collaboration on Children and Adolescents

Abstract

Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of SARS-CoV-2 infection among children and adolescents; however, these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifestations of COVID-19 among children. Furthermore, it is essential to improve understanding of SARS-CoV-2 interactions with comorbidities and co-infections such as HIV, tuberculosis, malaria, sickle cell disease and malnutrition, which are highly prevalent among children in sub-Saharan Africa. The African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents is conducting studies across Western, Central, Eastern, and Southern Africa to address existing knowledge gaps. This consortium is expected to generate key evidence to inform clinical practice and public health policymaking for COVID-19, while concurrently addressing other major diseases affecting children in African countries.

Published
2021

12. Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration.

Author

Nachega, Jean B., Sam-Agudu, Nadia A., Budhram, Samantha, Taha, Taha E., Vannevel, Valerie, Somapillay, Priya, Katuashi Ishoso, Daniel, Tshiasuma Pipo, Michel, Bongo-Pasi Nswe, Christian, Ditekemena, John, Ayele, Birhanu T., Machekano, Rhoderick N., Gachuno, Onesmus W., Kinuthia, John, Mwongeli, Nancy, Sekikubo, Musa, Musoke, Philippa, Kofi Agbeno, Evans, Umar, Lawal W., and Ntakwinja, Mukanire

Published
2021
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15. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.

Author

Nachega, Jean B., Sam-Agudu, Nadia A., Machekano, Rhoderick N., Rabie, Helena, van der Zalm, Marieke M., Redfern, Andrew, Dramowski, Angela, O'Connell, Natasha, Pipo, Michel Tshiasuma, Tshilanda, Marc B., Byamungu, Liliane Nsuli, Masekela, Refiloe, Jeena, Prakash Mohan, Pillay, Ashendri, Gachuno, Onesmus W., Kinuthia, John, Ishoso, Daniel Katuashi, Amoako, Emmanuella, Agyare, Elizabeth, and Agbeno, Evans K.

Published
2022
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16. The Critical Need for Pooled Data on Coronavirus Disease 2019 in African Children: An AFREhealth Call for Action Through Multicountry Research Collaboration.

Author

Sam-Agudu NA, Rabie H, Pipo MT, Byamungu LN, Masekela R, van der Zalm MM, Redfern A, Dramowski A, Mukalay A, Gachuno OW, Mongweli N, Kinuthia J, Ishoso DK, Amoako E, Agyare E, Agbeno EK, Mohammed Jibril A, Abdullahi AM, Amadi O, Mohammed Umar U, Ayele BT, Machekano RN, Nyasulu PS, Hermans MP, Otshudiema JO, Bongo-Pasi Nswe C, Kayembe JN, Mbala-Kingebeni P, Muyembe-Tamfum JJ, Aanyu HT, Musoke P, Fowler MG, Sewankambo N, Suleman F, Adejumo P, Tsegaye A, Mteta A, Noormahomed EV, Deckelbaum RJ, Zumla A, Mavungu Landu DJ, Tshilolo L, Zigabe S, Goga A, Mills EJ, Umar LW, Kruger M, Mofenson LM, and Nachega JB

Subjects
Adolescent, Africa South of the Sahara epidemiology, Child, Humans, SARS-CoV-2, COVID-19, Coinfection, Tuberculosis
Abstract

Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children and adolescents; and these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifestations of coronavirus disease 2019 (COVID-19) among children. Furthermore, it is essential to improve understanding of SARS-CoV-2 interactions with comorbidities and coinfections such as human immunodeficiency virus (HIV), tuberculosis, malaria, sickle cell disease, and malnutrition, which are highly prevalent among children in sub-Saharan Africa. The African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents is conducting studies across Western, Central, Eastern, and Southern Africa to address existing knowledge gaps. This consortium is expected to generate key evidence to inform clinical practice and public health policy-making for COVID-19 while concurrently addressing other major diseases affecting children in African countries., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Published
2021
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17. Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration.

Author

Nachega JB, Sam-Agudu NA, Budhram S, Taha TE, Vannevel V, Somapillay P, Ishoso DK, Tshiasuma Pipo M, Bongo-Pasi Nswe C, Ditekemena J, Ayele BT, Machekano RN, Gachuno OW, Kinuthia J, Mwongeli N, Sekikubo M, Musoke P, Agbeno EK, Umar LW, Ntakwinja M, Mukwege DM, Smith ER, Mills EJ, Otshudiema JO, Mbala-Kingebeni P, Kayembe JN, Mavungu Landu DJ, Muyembe Tamfum JJ, Zumla A, Langenegger EJ, and Mofenson LM

Subjects
Africa South of the Sahara epidemiology, COVID-19 mortality, Coinfection complications, Coinfection epidemiology, Female, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Intersectoral Collaboration, Pregnancy, Pregnant People, Premature Birth, Prospective Studies, Retrospective Studies, Risk Factors, SARS-CoV-2 pathogenicity, Socioeconomic Factors, COVID-19 complications, COVID-19 epidemiology, Pregnancy Complications, Infectious epidemiology, Pregnancy Complications, Infectious virology, Research
Abstract

In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health's COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa.

Published
2020
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