Abstract
Objective: This study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020.
Design: In this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures.
Setting: Research was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic.
Participants: Children were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19.
Results: A high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms.
Conclusions: This is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.
Keywords: COVID-19; epidemiology; molecular diagnostics; paediatrics; public health.
【저자키워드】 COVID-19, public health, Epidemiology, molecular diagnostics, paediatrics, 【초록키워드】 public health, SARS-CoV-2, Risk factors, Clinical symptoms, cross-sectional, SARS-COV-2 infection, children, COVID-19 pandemic, hospital, Comorbidity, Symptom, virus, Symptoms, clinics, Prevalence, Measures, symptomatic, community transmission, age, isothermal amplification, epidemiological data, SARS-CoV-2 RNA, School, molecular, characteristic, Care, questionnaire, myalgia, COVID-19 symptom, diarrhoea, age distribution, Health Service, no symptom, 95% CI, COVID-19 group, positive, laboratory-confirmed, widespread, robust, enrolled, tested, identify, carried, remained, presenting, sustained, seeking, with COVID-19, 【제목키워드】 SARS-COV-2 infection, children, risk factor, Care, cross-sectional survey, seeking, without symptom,