ABSTRACT
OBJECTIVE: To describe COVID-19 deaths among children and adolescents in Sergipe, Brazil. METHODS: Ecological study of all COVID-19 reported cases and deaths occurring in children and adolescents < 19 years of age in Sergipe reported by the health surveillance and mortality information systems of Sergipe's Health Secretary and hospital records. RESULTS: Of 37 deaths of children < 19 years old were reported up to 30 September 2020, corresponding to 4.87 deaths for 100 000 population < 19 years old. Most deaths occurred among infants (44.1/100 000), and this age group had the highest case fatality rate (15.3 %). Most children had comorbidities such as chronic neurological diseases (n = 7; 19%) and prematurity (n = 4; 11%). Most children who died (n = 18; 49%) were not admitted to intensive care units (ICUs). CONCLUSION: COVID-19 mortality in children and adolescents in Sergipe was higher than in other Brazilian states and in high-income countries. A large proportion of the deaths occurred among children with comorbidities and a minority of children were admitted to ICU, reflecting the limited provision of such beds in the State. Newborns and infants are a high-risk group that must have priority in health public policy.
OBJECTIF: Décrire les décès par COVID-19 chez les enfants et adolescents à Sergipe, au Brésil. MÉTHODES: Etude écologique de tous les cas et décès par COVID-19 signalés chez des enfants et des adolescents <19 ans à Sergipe rapportés par les systèmes de surveillance de la santé et d'information sur la mortalité du Secrétariat de la Santé et les dossiers hospitaliers de Sergipe. RÉSULTATS: 37 décès d'enfants <19 ans ont été signalés au 30 septembre 2020, correspondant à 4,87 décès pour 100.000 habitants de <19 ans. La plupart des décès sont survenus chez des nourrissons (44,1/100.000) et ce groupe d'âge avait le taux de létalité le plus élevé (15,3%). La plupart des enfants présentaient des comorbidités telles que des maladies neurologiques chroniques (n = 7; 19%) et une prématurité (n = 4; 11%). La plupart des enfants décédés (n = 18; 49%) n'avaient pas été admis dans des unités de soins intensifs. CONCLUSION: La mortalité par COVID-19 chez les enfants et les adolescents de Sergipe était plus élevée que dans les autres Etats brésiliens et dans les pays à revenu élevé. Une grande partie des décès est survenue chez des enfants souffrant de comorbidités et une minorité d'enfants avaient été admis aux soins intensifs, ce qui reflète la disponibilité limitée de ce type de lits dans l'Etat. Les nouveau-nés et les nourrissons constituent un groupe à haut risque qui doit avoir la priorité dans les politiques de santé publiques.
Subject(s)
COVID-19/mortality , Adolescent , Age Distribution , Brazil/epidemiology , Child , Child, Preschool , Comorbidity , Female , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Intensive Care Units , MaleABSTRACT
BACKGROUND: Micronutrient deficiencies are the most prevalent form of malnutrition worldwide. Although commonly related to underweight, micronutrient deficiencies can occur in both normal and overweight children in medium- and low-income populations undergoing nutritional transition. OBJECTIVE: To describe haemoglobin and micronutrient levels in infants from a low-income area in Brazil in relation to their weight-for-length Z-score. METHODS: A cross-sectional survey was undertaken of 2-11-month-old infants in Laranjeiras, a small urban community in North-east-Brazil between April 2009 and February 2010. Anthropometry and assays for haemoglobin, ferritin, plasma zinc, copper and selenium and erythrocyte zinc and copper concentrations were investigated. RESULTS: The total number of full-term infants born in the study period was 222, of whom 153 were available for the study. Three (2%) children were wasted, 98 (66%) were of normal weight, 37 (25%) were at risk of overweight and 11 (7%) were overweight or obese. Nearly all (97%) children had at least one micronutrient deficiency, 102 (67%) had anaemia, 86 (58%) and 100 (67%) had plasma and erythrocyte zinc deficiency, respectively, and 7 (5%) and 113 (76%) had plasma and erythrocyte copper deficiency, respectively. 138 (91%) children had selenium deficiency. Except for plasma zinc, the proportion of infants with micronutrient deficiencies did not differ by weight-for-length status. CONCLUSIONS: The increased risk of overweight and micronutrient deficiencies in this population highlights the need to address the double burden of excess weight with micronutrient deficiencies in medium- and low-income settings.
