Journal article
Presentation and outcomes of Lassa fever in children in Nigeria: a prospective cohort study (LASCOPE)
- Abstract:
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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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 574.6KB, Terms of use)
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- Publisher copy:
- 10.1093/jpids/piae083
Authors
- Funder identifier:
- https://ror.org/031jv9v19
- Grant:
- RIA2016E-1612
- Publisher:
- Oxford University Press
- Journal:
- Journal of the Pediatric Infectious Diseases Society More from this journal
- Volume:
- 13
- Issue:
- 10
- Pages:
- 513–522
- Place of publication:
- England
- Publication date:
- 2024-08-21
- Acceptance date:
- 2024-08-19
- DOI:
- EISSN:
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2048-7207
- ISSN:
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2048-7193
- Pmid:
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39167706
- Language:
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English
- Keywords:
- Pubs id:
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2023533
- Local pid:
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pubs:2023533
- Deposit date:
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2024-09-02
Terms of use
- Copyright holder:
- Duvignaud et al.
- Copyright date:
- 2024
- Rights statement:
- © The Author(s) 2024. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https:// creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited.
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