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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.
- COVID-19
- epidemiology
- paediatrics
- public health
- molecular diagnostics
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. The manuscript includes all methods, values and information needed to replicate the study, and the sources used are indicated. The whole database of the study is available upon request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. The manuscript includes all methods, values and information needed to replicate the study, and the sources used are indicated. The whole database of the study is available upon request.
Supplementary materials
Supplementary Data
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Footnotes
Twitter @jorgehuete
Contributors JAH-P conceived the study and its design, wrote the original draft of the manuscript, accepts full responsibility for the work and/or the conduct of the study, had access to the data, take responsibility for the integrity of the data and accuracy of the analysis and controlled the decision to publish. The manuscript’s guarantor affirms that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. CC-R and LP-M contributed to data collection, organised and entered data. KCE contributed to statistical analyses and interpretation. SS contributed to data collection, analyses and interpretation. AH contributed to the study design, data analyses, and writing. All authors contributed to the final drafting of the manuscript and have seen and approved the submitted version of this manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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