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\begin{document}

\title{Epidemiology of SARS-CoV-2 infection and SARS-CoV-2 positive hospital
admissions among children in South Africa}



\author[1]{Tendesayi Kufa}%
\author[1]{Waasila  Jassat }%
\author[1]{Cheryl Cohen}%
\author[1]{Stefano Tempia}%
\author[1]{Maureen Masha }%
\author[1]{Nicole Wolter}%
\author[1]{Sibongile Walaza}%
\author[1]{Anne von Gottberg}%
\author[1]{Nelesh  Govender }%
\author[1]{Gillian  Hunt}%
\author[1]{Andronica Shonhiwa}%
\author[1]{Joy  Ebonwu}%
\author[1]{Genevie M. Ntshoe}%
\author[1]{Wellington  Maruma }%
\author[1]{Poncho Bapela }%
\author[1]{Nomathamsanqa Ndhlovu}%
\author[1]{Hlengani Mathema}%
\author[1]{Motshabi  Modise }%
\author[1]{Liliwe Shuping}%
\author[1]{Pinky Manana}%
\author[2]{David  Moore }%
\author[2]{Ziyaad Dangoor}%
\author[2]{Charl Verwey}%
\author[2]{Shabir  Madhi}%
\author[2]{Haroon  Saloojee}%
\author[3]{Heather J. Zar}%
\author[1]{Lucille Blumberg}%
\affil[1]{National Institute for Communicable Diseases}%
\affil[2]{University of the Witwatersrand Faculty of Health Sciences}%
\affil[3]{University of Cape Town Faculty of Health Sciences}%


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  \date{May 08, 2024}


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\begin{abstract}
Introduction: We describe epidemiology and outcomes of confirmed
SARS-CoV-2 infection and admissions among children \textless{}18 years
in South Africa, an upper-middle income setting with high inequality.
Methods: Laboratory and hospital COVID-19 surveillance data, 28 January
- 19 September 2020 was used. Testing rates were calculated as number of
tested for SARS-CoV-2 divided by population at risk; test positivity
rates were calculated as positive tests divided by total number of
tests. In-hospital case fatality ratio (CFR) was calculated based on
hospitalized positive admissions with outcome data who died in-hospital
and death was judged SARS-CoV-2 related by attending physician.
Findings: 315,570 children aged \textless{}18 years were tested for
SARS-CoV-2; representing 8.9\% of all 3,548,738 tests and 1.6\% of all
children in the country. Of children tested, 46,137 (14.6\%) were
positive. Children made up 2.9\% (n=2,007) of all SARS-CoV-2 positive
admissions to sentinel hospitals. Among children, 47 died (2.6\%
case-fatality). In-hospital deaths were associated with male sex
{[}adjusted odds ratio (aOR) 2.18 (95\% confidence intervals (CI) 1.08 -
4.40){]} vs female; age \textless{}1 year {[}aOR 4.11 (95\% CI
1.08-15.54){]}, age 10-14 years {[}aOR 4.20 (95\% CI1.07-16.44){]}, age
15-17 years {[}aOR 4.86 (95\% 1.28 -18.51){]} vs age 1-4 years;
admission to a public hospital {[}aOR 5.07(95\% 2.01 -12.76){]} vs
private hospital and [?]1 underlying conditions {[}aOR 12.09 (95\% CI
4.19-34.89){]} vs none Conclusions: Children with underlying conditions
were at greater risk of severe SARS-CoV-2 outcomes. Children
\textgreater{} 10 years and those with underlying conditions should be
considered for increased testing and vaccination.%
\end{abstract}%



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\textbf{Hosted file}

\verb`COVID-19 in Children - Manuscript_withfigs&tables_IORV.docx`  available at \url{https://authorea.com/users/436931/articles/538926-epidemiology-of-sars-cov-2-infection-and-sars-cov-2-positive-hospital-admissions-among-children-in-south-africa}

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