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

作者：Alexandre Duvignaud, Ijeoma Chukwudumebi Etafo, Marie Jaspard, Qasim Salau, Béatrice Serra, Abiodun J. Kareem, Sylvain Juchet, Tolulope Jegede, Delphine Gabillard, Abiodun Tolani Abidoye, Camille Le Gal, Chukwuyem Abejegah, Sampson Omagbemi Owhin, Kevin Okwaraeke, Mahamadou Doutchi, Jackson Katembo Vihundira, Rene-M Besong-Lache, Benjamin Séri, Marion Bérerd-Camara, Alex P. Salam, Adebola Olayinka, Peter Horby, Ephraim Ogbaini-Emovon, Sophie Duraffour, Liasu Adeagbo Ahmed, Stephan Günther, Akinola Nelson Adedosu, Xavier Anglaret, Denis Malvy, Hans-Jörg Lang, Oladele Oluwafemi Ayodeji · 发表于：Journal of the Pediatric Infectious Diseases Society · 年份：2024 · DOI：10.1093/jpids/piae083 · 被引用次数：11 · 研究领域：Viral Infections and Outbreaks Research、Disaster Response and Management、COVID-19 and healthcare impacts

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...