Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;16(1):34-47.
doi: 10.1111/irv.12916. Epub 2021 Nov 18.

Epidemiology of SARS-CoV-2 infection and SARS-CoV-2 positive hospital admissions among children in South Africa

Tendesayi Kufa  1   2 , Waasila Jassat  1 , Cheryl Cohen  1   2 , Stefano Tempia  2   3   4 , Maureen Masha  1 , Nicole Wolter  1   5 , Sibongile Walaza  1 , Anne von Gottburg  1   5 , Nelesh P Govender  1   5 , Gillian Hunt  1   5 , Andronica Moipone Shonhiwa  1 , Joy Ebonwu  1 , Genevie Ntshoe  1   6 , Wellington Maruma  1 , Poncho Bapela  1 , Nomathamsanqa Ndhlovu  1 , Hlengani Mathema  1 , Motshabi Modise  1 , Liliwe Shuping  1 , Pinky N Manana  1   5 , David Moore  7 , Ziyaad Dangor  7 , Charl Verwey  7 , Shabir A Madhi  8   9 , Haroon Saloojee  7 , Heather J Zar  10 , Lucille Blumberg  1
Affiliations

Epidemiology of SARS-CoV-2 infection and SARS-CoV-2 positive hospital admissions among children in South Africa

Tendesayi Kufa et al. Influenza Other Respir Viruses. 2022 Jan.

Abstract

Introduction: We describe epidemiology and outcomes of confirmed SARS-CoV-2 infection and positive admissions among children <18 years in South Africa, an upper-middle income setting with high inequality.

Methods: Laboratory and hospital COVID-19 surveillance data, 28 January - 19 September 2020 was used. Testing rates were calculated as number of tested for SARS-CoV-2 divided by population at risk; test positivity rates were calculated as positive tests divided by total number of tests. In-hospital case fatality ratio (CFR) was calculated based on hospitalized positive admissions with outcome data who died in-hospital and whose death was judged SARS-CoV-2 related by attending physician.

Findings: 315 570 children aged <18 years were tested for SARS-CoV-2; representing 8.9% of all 3 548 738 tests and 1.6% of all children in the country. Of children tested, 46 137 (14.6%) were positive. Children made up 2.9% (n = 2007) of all SARS-CoV-2 positive admissions to sentinel hospitals. Among children, 47 died (2.6% case-fatality). In-hospital deaths were associated with male sex [adjusted odds ratio (aOR) 2.18 (95% confidence intervals [CI] 1.08-4.40)] vs female; age <1 year [aOR 4.11 (95% CI 1.08-15.54)], age 10-14 years [aOR 4.20 (95% CI1.07-16.44)], age 15-17 years [aOR 4.86 (95% 1.28-18.51)] vs age 1-4 years; admission to a public hospital [aOR 5.07(95% 2.01-12.76)] vs private hospital and ≥1 underlying conditions [aOR 12.09 (95% CI 4.19-34.89)] vs none.

Conclusions: Children with underlying conditions were at greater risk of severe SARS-CoV-2 outcomes. Children > 10 years, those in certain provinces and those with underlying conditions should be considered for increased testing and vaccination.

Keywords: COVID-19; adolescents; children; incidence; mortality; testing rate.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
SARS‐CoV2 rRT‐PCR: (A) number of tests and percent positive, (B) number of new positive cases, and (C) number of associated‐ hospital admissions among children <18 years, by age and sex, South Africa, March 1, 2020, to September 19, 2020. rRT‐PCR, real‐time reverse transcriptase polymerase chain reaction
FIGURE 2
FIGURE 2
Weekly number of SARS‐CoV‐2 rRT‐PCR8* tests and percent positive among children <18 years by age, South Africa, March 1, 2020 to September 19, 2020. rRT‐PCR, real‐time reverse transcriptase polymerase chain reaction
FIGURE 3
FIGURE 3
Proportion of SARS‐CoV‐2 associated hospital admissions of children aged <18 years with reported underlying medical conditions among those with ≥1 underlying conditions, by age group, South Africa, March 1, 2020, to September 19, 2020
See this image and copyright information in PMC

References

    1. World Health Organization . Coronavirus Disease (COVID‐19) Situation report. Geneva, Switzerland 3 August 2020 2020.
    1. Mofenson LM, Idele P, Anthony D, Requejo J, You D, Luo C, Peterson S. The Evolving Epidemiologic and Clinical Picture of SARS‐CoV‐2 and COVID‐19 Disease in Children and Young People. UNICEF Office of Research July 2020 2020.
    1. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID‐19 among children in China. Pediatrics. 2020;145(6). - PubMed
    1. Liguoro I, Pilotto C, Bonanni M, et al. SARS‐COV‐2 infection in children and newborns: a systematic review. Eur J Pediatr. Jul 2020;179(7):1029‐1046. - PMC - PubMed
    1. Academy of Paediatrics . Children and COVID‐19: state‐level data report. 2020.

Publication types