London School of Hygiene and Tropical Medicine/College of Medicine and Allied Health Sciences Research Collaboration, Kambia, Sierra Leone.
Kambia District Health Medical Team, Ministry of Health and Sanitation, Freetown, Sierra Leone.
Pan Afr Med J. 2020 Oct 27;37(Suppl 1):28. doi: 10.11604/pamj.supp.2020.37.28.26312. eCollection 2020.
Studies reporting the clinical presentations of COVID-19 in children in sub-Saharan Africa are few, especially from resource-constrained countries. This case series reports the demographic and clinical characteristics and laboratory findings of confirmed cases of COVID-19 in children seen at a district hospital in Sierra Leone. This is a report of nine COVID-19 paediatric cases managed at a secondary level hospital in Kambia District, Northern Sierra Leone. Each child was detected by contact tracing after an infected adult was identified by the COVID-19 response team. The clinical symptoms at presentation, clinical courses, and treatments instituted and patient outcomes are discussed in the context of the facilities available at a typical West African district hospital. Nine out of 30 individuals with confirmed COVID-19 infection who presented to the hospital from 24 April to 20 September 2020 and who were admitted to the isolation center of the hospital were in the paediatric age group. The mean age (SD) and median (IQR) of the children were 69.0 ± 51.7months and 84.0 (10.5, 108.0) months, respectively; five (55.6%) were males. The children were asymptomatic or only had mild illnesses and none required intranasal oxygen or ventilatory support. In the five symptomatic children, the most common symptoms were fever (40%) and cough (40%). All children had normal haemoglobin, platelet and white blood cell (WBC) count. Four children had a positive malaria test and were treated with a complete course of anti-malaria medications. No child received steroid or had specific anti-COVID-19 treatment. All children stayed in the isolation center for 14 days and were re-tested for COVID-19 two weeks after initial diagnosis. No complications have been reported in any of them since discharge. The proportion of children among COVID-19 infected cases seen in a rural community in Sierra Leone was 30%. Fever was the most common symptom and malaria was confirmed in 40% of the infected children. This has significant implication on the diagnosis of COVID-19 in malaria-endemic settings and on how best to manage children who present with fever during the COVID-19 pandemic.
在撒哈拉以南非洲，报告 COVID-19 在儿童中临床表现的研究很少，特别是来自资源有限国家的研究。本病例系列报告了塞拉利昂一个地区医院收治的 COVID-19 确诊病例的人口统计学和临床特征以及实验室结果。这是在塞拉利昂北部坎比亚区二级医院管理的 9 例 COVID-19 儿科病例的报告。每个孩子都是在 COVID-19 应对小组发现一名受感染的成年人后通过接触追踪发现的。根据典型西非地区医院的可用设施，讨论了发病时的临床症状、临床过程、实施的治疗和患者结局。在 2020 年 4 月 24 日至 9 月 20 日期间，有 30 名 COVID-19 感染确诊者到医院就诊，其中 9 人因感染住院，他们均为儿科年龄组。儿童的平均年龄（标准差）和中位数（IQR）分别为 69.0 ± 51.7 个月和 84.0（10.5，108.0）个月，其中 5 人（55.6%）为男性。儿童无症状或仅有轻度疾病，无一例需要经鼻吸氧或通气支持。在 5 例有症状的儿童中，最常见的症状是发热（40%）和咳嗽（40%）。所有儿童的血红蛋白、血小板和白细胞（WBC）计数均正常。4 名儿童疟疾检测呈阳性，并接受了完整疗程的抗疟药物治疗。没有儿童接受皮质类固醇治疗或接受特定的抗 COVID-19 治疗。所有儿童均在隔离中心停留 14 天，并在初次诊断后两周对 COVID-19 进行重新检测。自出院以来，他们均未报告任何并发症。在塞拉利昂农村社区的 COVID-19 感染病例中，儿童的比例为 30%。发热是最常见的症状，在感染儿童中，疟疾的确诊率为 40%。这对疟疾流行地区 COVID-19 的诊断以及在 COVID-19 大流行期间如何最好地管理发热儿童具有重要意义。
