According to a recently published study involving researchers from the Institute of Human Virology Nigeria (IHVN), and Ahmadu Bello University, Zaria, Nigeria, 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.
Reference: 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

Dr. Faisal Shuaib, the Executive Director, National Primary Health Care Development Agency (NPHCDA) on Tuesday reiterated the fact that till date, Nigeria has not recorded any death arising from COVID-19 vaccination.

Shuaib gave this hint while updating Nigerians on the status of COVID-19.

He said this should further serve to convince everyone that COVID-19 vaccines are safe.

He stated that the second and booster doses are critical to achieving high protection against the virus especially as it keeps mutating.

His words, “As you are aware, Nigeria introduced booster dose of COVID-19 vaccine on the 10th of December 2021, following the recommendation by WHO for people who have received two doses of AstraZeneca, Moderna, Pfizer Bio-N-Tech or one dose of Johnson & Johnson vaccines. In line with his exemplary leadership style, President Muhammadu Buhari received his booster dose of COVID-19 vaccine on Tuesday the 21st of December 2021. So far, 416,980 Nigerians have received their booster dose. Again, this is a clear indication that many more Nigerians are determined to achieve maximum protection against COVID-19.

“As you are aware, as the holiday season approached, we began to see an increase in the number of cases not just in Nigeria but also globally. In Nigeria, several unvaccinated individuals were migrating from the cities to the rural areas and back to the cities. Globally, we saw the emergence of new variants such as IHU variant in France which is said to have 46 mutations, Deltacron in Cyprus and the Omicron variant still being highly infectious with a BA.2 subvariant rapidly spreading. More of our citizens were coming down with the infection. Luckily for our vaccinated population, those who came down with the COVID-19 infection had mild symptoms which they managed at home due to the immunity the vaccination provided them. If they were not vaccinated, we cannot predict how these cases would have turned out. Vaccination prevents you from severe disease, hospitalization and death.

“The reason for the emergence of these variants, is because there is still a large proportion of the eligible population who have not yet been vaccinated and this has given the virus time to mutate and fight back. It is important that we protect ourselves and our loved ones by getting the jab. Our vaccination exercise was expanded to enable all eligible persons have easier access. All vaccination sites are open to eligible persons, 18 years and above for first, second and booster doses. We call on Nigerians to avail themselves of this opportunity in the on-going mass vaccination exercise to get vaccinated against COVID-19.

“We would also like to inform the general public that in this phase of COVID-19 mass vaccination we plan to integrate the campaign with childhood immunization and other PHC services. What this simply means is that alongside the COVID-19 vaccines, childhood vaccines will also be available at COVID-19 vaccination sites. Consequently, parents or guardians with children aged zero to 23 months are urged to take them along to the vaccination sites. The childhood vaccines protect against polio, whooping cough, measles, yellow fever, tetanus, tuberculosis, and other childhood preventable diseases. This is to ensure that while we are trying so hard to control the transmission of COVID-19, we do not neglect other PHC services or even have outbreaks of childhood vaccine preventable diseases on our hands” ,he explained.

He further stated that, ” I appreciate the invaluable support in creating awareness and mobilizing Nigerians for COVID-19 vaccine uptake. Our record as of today, Tuesday January 25th 2022 shows that 14,093,873 eligible persons have received the first dose of COVID-19 vaccine in Nigeria while 5,252,406 eligible Nigerians have been fully vaccinated. However, as one would expect, these results are not evenly distributed across the states of the Federation. Our deep dive into state performances reveals that Nasarawa, Jigawa, FCT, Ogun and Kwara have remained the top 5 performing states on COVID-19 vaccine uptake. It is noteworthy to mention that Jigawa and Lagos have each vaccinated about 1.5million eligible Nigerians with the first dose, while FCT, Nasarawa, Lagos and Delta are leading on second dose administration with more than 10% of eligible populations in each of the states already vaccinated. On the walls of this hall, you can see the States performance charts displayed. It is in our spirit of transparency and accountability that we consider it important to keep Nigerians informed about the progress of COVID-19 vaccination in the states. We also believe that this information will serve as an encouragement for the states in the vaccine uptake, going forward.

“I am sure the question plaguing your mind is what are the best performing States doing differently and what is our recommendations to States on how to ramp up Covid-19 and childhood vaccinations. The following are our Prayers to State Governors:
a. Governor should convene a meeting of LGA Chairmen, traditional, political, religious leaders and the health team. He should charge them with the responsibility of ensuring that the populace within their constituencies are duly vaccinated.
b. The Governor should charge the LGA Chairmen and health teams to develop a daily, weekly and monthly Covid-19 and Childhood vaccination targets based on the total eligible populations
c. The Governor can meet with the LGA Chairmen and health teams on a weekly basis, to review the results of the campaigns and confirm if these targets are being met. This can also be an agenda on the weekly State Executive Council meetings.
d. The Governor can apply accountability mechanisms to the vaccination process by publically rewarding LGA teams that perform the highest and sanctions teams that do not meet the minimum requirements despite the supports. This can be done in a fortnightly ceremony where the Governor shakes the best performers and issue certificates or plaques of excellence.

“We understand the challenges of undue vaccine hesitancy in the country, we strongly believe that a more committed approach to implementing mass vaccination will lead to improved vaccine uptake. This is why our current vaccination phase emphasizes state supervision support to ramp up vaccine uptake especially in low performing states.

“We want to acknowledge the strong leadership displayed by many Governors in ensuring that their citizens are vaccinated and encourage them to do even more, so we can further improve our vaccination coverage. Last year, the daily Covid-19 vaccination coverage was about 100,000 people per day. Between December 2021 and January 2022, we have more than doubled this vaccination rate to over 200,000 per day. With the talents and capabilities of Nigerians, I know we can do better and we must improve to we protect all Nigerians”, he added.