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

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.

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Publication Details

Journal
Journal of the Pediatric Infectious Diseases Society
Published
2024-08-19
DOI
https://doi.org/10.1093/jpids/piae083
Citations
7
Primary Topic
Viral Infections and Outbreaks Research
Type
article
Field-Weighted Citation Impact
2.72

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article

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

Alexandre Duvignaud, Adebola Olayinka, Abiodun J. Kareem, Xavier Anglaret et al.
7 citations
Journal of the Pediatric Infectious Diseases Society
Viral Infections and Outbreaks Research
2.72
article

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

Alexandre Duvignaud, Adebola Olayinka, Abiodun J. Kareem, Xavier Anglaret, Benjamin Séri, Alex P. Salam, Sampson Omagbemi Owhin, Sophie Duraffour, Oladele Oluwafemi Ayodeji, Ijeoma Chukwudumebi Etafo, Mahamadou Doutchi, Ephraim Ogbaini-Emovon, Akinola Nelson Adedosu, Abiodun Tolani Abidoye, Stephan Günther, Peter Horby, Chukwuyem Abejegah, Camille Le Gal, Tolulope Jegede, Jackson Katembo Vihundira, Marion Bérerd-Camara, Qasim Salau, Sylvain Juchet, Kevin Okwaraeke, Delphine Gabillard, Rene-M Besong-Lache, Hans-Jörg Lang, Béatrice Serra, Denis Malvy, Marie Jaspard, Liasu Adeagbo Ahmed
article en
7 citations

Abstract

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.

Journal of the Pediatric Infectious Diseases SocietyVol. 13(10)
Université de Bordeaux (FR), Inserm (FR), Witten/Herdecke University (DE), Angkor Hospital for Children (KH), Sorbonne Université (FR), University of Oxford (GB), Alliance for International Medical Action (SN), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Saint-Antoine (FR), Bordeaux Population Health (FR), Hôpital Pellegrin (FR), German Center for Infection Research (DE), Federal Medical Centre (NG), Programme PAC-CI (CI), Federal Medical Centre (NG), Université André Salifou (NE), Irrua Specialist Teaching Hospital (NG), Nigeria Centre for Disease Control (NG), Institut de Recherche pour le Développement (FR), Bernhard Nocht Institute for Tropical Medicine (DE)
Institut National de la Santé et de la Recherche Médicale, Université de Bordeaux
Openalex Percentile: Top 9%
Viral Infections and Outbreaks Research
2.72
DOIOpen Access PDFOpenAlex
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