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. 2024 Nov 4;13(10):513-522.
doi: 10.1093/jpids/piae083.

Presentation and Outcomes of Lassa Fever in Children in Nigeria: A Prospective Cohort Study (LASCOPE)

Alexandre Duvignaud  1   2   3   4 , Ijeoma C Etafo  5 , Marie Jaspard  1   3   4   6 , Qasim Salau  7 , Béatrice Serra  1   3   4 , Abiodun J Kareem  7 , Sylvain Juchet  1   3   4 , Tolulope O Jegede  7 , Delphine Gabillard  1   3 , Abiodun T Abidoye  5 , Camille Le Gal  4 , Chukwuyem Abejegah  5 , Sampson Owhin  5 , Kevin Okwaraeke  4 , Mahamadou Doutchi  4   8 , Jackson Katembo Vihundira  4 , Rene-M Besong-Lache  4 , Benjamin Seri  3 , Marion Bérerd-Camara  4 , Alex P A Salam  9 , Adebola Olayinka  10 , Peter Horby  9 , Ephraim Ogbaini-Emovon  11 , Sophie Duraffour  12   13 , Liasu A Ahmed  14 , Stephan Günther  12   13 , Akinola N Adedosu  15 , Xavier Anglaret  1   3   4 , Denis Malvy  1   2   3   4 , Hans J Lang  4   16 , Oladele O Ayodeji  5
Affiliations

Presentation and Outcomes of Lassa Fever in Children in Nigeria: A Prospective Cohort Study (LASCOPE)

Alexandre Duvignaud et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Data on the presentation, management, and outcomes of Lassa fever (LF) in children are limited.

Methods: Description of the clinical and biological features, treatment, and outcomes of reverse transcriptase and polymerase chain reaction (RT-PCR)-confirmed LF in children aged under 15, enrolled in the LASsa fever clinical COurse and Prognostic factors in an Epidemic context (LASCOPE) prospective cohort study in Nigeria between April 2018 and February 2023.

Results: One hundred twenty-four children (aged under 12 months: 19; over 12 months: 105) were hospitalized with RT-PCR-confirmed LF. All received intravenous ribavirin. During follow-up, 99/124 (80%) had fever; 71/124 (57%) had digestive symptoms, vomiting (n = 56/122, 46%) and abdominal pain (n = 34/78 aged ≥5 years, 44%) more often than diarrhea (n = 19/124, 15%); 17/124 (14%) had hemorrhagic signs; 44/112 (39%) had a hematocrit lower than 25%, of whom 32/44 (73%) received transfusions; 44/88 (50%) developed hypotension; 18/112 (16.1%) developed kidney disease improving global outcome (KDIGO) ≥2 acute kidney injury; 10/112 (8.9%) had KDIGO 3 acute kidney failure; 4/124 (3.2%) underwent renal replacement therapy. Seven children died, including 4 aged under 12 months (case fatality rate: under 12 months-22%, 95% confidence interval (CI): 7%-48%; over 12 months-2.9%, 95% CI: 0.7%-8.7%). In univariable analysis, age (P = .003), impaired consciousness (P = .026), and Lassa RT-PCR Ct value (P = .006) were associated with Day 30 mortality.

Conclusions: The fatality rate for children over 12 months hospitalized with LF was lower than that previously reported for adults. Hypotension and acute kidney injury were the most frequent organ dysfunctions. Bleeding was relatively infrequent. Anemia and the need for transfusion were common, the relative contribution of ribavirin-induced hemolysis being unknown.

Keywords: Lassa fever; Nigeria; acute kidney injury; anemia; children; prognosis.

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