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Multi-Country African Research Reports High Rates of COVID-19-Related Deaths Among Hospitalized Children and Adolescents

A recently published study involving researchers from the Institute of Human Virology Nigeria (IHVN), and Ahmadu Bello University, Zaria, Nigeria, has revealed that African children and adolescents hospitalized with COVID-19 experience high mortality rates.

The study, titled “Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized with COVID-19 in 6 Sub-Saharan African Countries,” was conducted by a collaboration under AFREhealth (the African Forum for Research and Education in Health), a consortium of cross-disciplinary health personnel across Africa.

The AFREhealth study collected data from 25 health facilities across Nigeria, Ghana, Democratic Republic of the Congo, Kenya, South Africa, and Uganda. The study included 469 African children and adolescents aged 3 months to 19 years hospitalized with COVID-19 between March and December 2020, and reported a high overall mortality rate of 8.3%, compared with 1% or less reported from Europe and North America. Furthermore, African children less than a year old and with pre-existing non-communicable diseases were more likely to have poorer outcomes, including intensive care requirement, and death.

Eighteen participants had suspected or confirmed multisystem inflammatory syndrome, and 4 of these children died.

IHVN Senior Technical Advisor for Paediatric and Adolescent HIV Dr. Nadia Sam-Agudu, who is also an Associate Professor of Paediatrics at the University of Maryland School of Medicine, is a co-first author of the publication and led the West Africa team. According to Dr. Sam-Agudu, “This study provides important information about COVID-19 among African children that was not previously available at this scale.  We now have evidence from multiple countries to show that African children also experience severe COVID-19, they experience multisystem inflammatory syndrome, some require intensive care, and some also die, and at much higher rates than outside Africa.”

She urged Nigerian authorities to act upon study findings “to protect children; including the expansion of vaccine approvals and procurements to include children, as variants emerging since our study’s completion have either caused more severe disease and/or more cases overall. We cannot leave children behind in the pandemic response.”

According to IHVN Chief Executive Officer Dr. Patrick Dakum, “This data from Dr. Sam-Agudu and AFREhealth collaborators puts science from Nigeria and the rest of Africa squarely on the map for pandemic-responsive research, particularly for young populations. We will continually work towards contributing to research discoveries in Nigeria, West Africa and beyond,” he said.

Executive Director of the IHVN International Research Center of Excellence Prof. Alash’le Abimiku also noted that, “The high impact pediatric COVID-19 findings of the collaborative research underscores the value of sustained investments in strong research institutions, collaborations and leadership in Nigeria and across Africa.  We can generate rigorous local data to guide local, regional and international health policy and practice,” she said

The Director-General of the Nigeria Centre for Disease Control Dr. Ifedayo Adetifa remarked: “The AFREhealth study findings show that COVID-19 affects children and can cause severe consequences. Thus, we seriously need to factor children into age-disaggregated COVID-19 disease surveillance and reporting, and consider COVID-19 illness when they present to the hospital. Furthermore, the high in-hospital mortality rate reported indicates a need for investments in critical care for children in African settings. We need more of such rigorous multicenter studies to inform evidence-based policy-making in Nigeria and other African countries.”

The research was published in the international JAMA Pediatrics journal, the highest-ranked paediatric journal in the world. Prof. Umar Lawal of the College of Medicine, Ahmadu Bello University Zaria led the Nigeria team for the study, which was led overall by Principal Investigator Prof. Jean Nachega of the University of Pittsburgh USA and Stellenbosch University, South Africa.


Nachega JB, Sam-Agudu NA, Machekano RN, et al. Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized with COVID-19 in 6 Sub-Saharan African Countries. JAMA Pediatr. Published online January 19, 2022. doi:10.1001/jamapediatrics.2021.6436. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2788373