ArticleJournal of the Pediatric Infectious Diseases Society2023
Changing Epidemiology of COVID-19 in Children and Adolescents Over Four Successive Epidemic Waves in South Africa, 2020-2022.
Article in Journal of the Pediatric Infectious Diseases Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Severe, primary, and incidental COVID-19 in hospitalised children, South Africa: 2020-2023.Journal of global health · 2026Article
- Longitudinal SARS-CoV-2 seroprevalence among learners, parents, and teachers in a South African school community.Frontiers in public health · 2026Article
- Characterizing acute and persistent symptoms of COVID-19 among adults and children in rural Zambia, 2020-2022.PLOS global public health · 2026Article
- Aetiological Fraction of Influenza, Respiratory Syncytial Virus and Other Respiratory Pathogens in Infants Aged < 1 Year Hospitalised With Respiratory and Non-Respiratory Medical Illness in South Africa, 2016-2018.Influenza and other respiratory viruses · 2025Article
- Burden of SARS-CoV-2 infection and severe illness in South Africa (March 2020-August 2022): a synthesis of epidemiological data.BMJ public health · 2025Article
- Fatal SARS-CoV-2 Infection among Children, Japan, January-September 2022Emerging infectious diseases · 2024Article
- SARS-CoV-2 detection in pediatric dental clinic wastewater reflects the number of local COVID-19 cases in children under 10 years old.Scientific reports · 2024Article
- Risk Factors for Severe COVID-19 Among Children and Adolescents Enrolled in Acute Respiratory Infection Sentinel Surveillance in South Africa, 2020-2022.Influenza and other respiratory viruses · 2024Article
- Characteristics of infections with ancestral, Beta and Delta variants of SARS-CoV-2 in the PHIRST-C community cohort study, South Africa, 2020-2021.BMC infectious diseases · 2024Article
- The deadly impact of COVID-19 among children from Latin America: The case of Ecuador.Frontiers in pediatrics · 2023Article
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSouth Africa experienced four waves of SARS-CoV-2 infection, dominated by Wuhan-Hu, Beta, Delta, and Omicron (BA.1/BA.2). We describe the trends in SARS-CoV-2 testing, cases, admissions, and deaths among children and adolescents in South Africa over successive waves.
methodsWe analyzed national SARS-CoV-2 testing, case, and admissions data from March 2020 to February 2022 and estimated cumulative rates by age group for each endpoint. The severity in the third versus the fourth wave was assessed using multivariable logistic regression.
resultsIndividuals ≤18 years comprised 35% (21,008,060/60,142,978) of the population but only 12% (424,394/3,593,644) of cases and 6% (26,176/451,753) of admissions. Among individuals ≤18 years, infants had the highest admission (505/100,000) rates. Testing, case, and admission rates generally increased successively in the second (Beta) and third (Delta) waves among all age groups. In the fourth (Omicron BA.1/BA.2) wave, the case rate dropped among individuals ≥1 year but increased among those <1 year. Weekly admission rates for children <1 year (169/100,000) exceeded rates in adults (124/100,000) in the fourth wave. The odds of severe COVID-19 in all admitted cases were lower in the fourth wave versus the third wave in each age group, but they were twice as high in admitted cases with at least one comorbidity than those without.
conclusionsThe admission rate for children <5 years was higher in the fourth wave than in previous waves, but the overall outcomes were less severe. However, children with at least one comorbidity had increased odds of severe disease, warranting consideration of prioritizing this group for vaccination.
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