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PA-753 Covid-19 in children: Immune response to SARS-CoV-2 infection in children under 5, Guinea-Bissau
  1. Elsi Ca1,
  2. Isaquel Silva1,2,
  3. Sebastian Nielsen1,2,
  4. Frederik Schaltz-Buchholzer1,2,
  5. Christine Stabell Benn1,3
  1. 1Bandim Health Project, Guinea-Bissau
  2. 2University of Southern Denmark, Denmark
  3. 3OPEN, Department of Clinical Research, University of Southern Denmark, Denmark


Background Children under the age of five are generally more susceptible to respiratory viral infections, but during the pandemic there have been many reports that children have a low risk of severe SARS-CoV-2 infection. It has been questioned to what extend children have been infected with SARS-CoV-2. We therefore conducted a survey to determine the prevalence among children under 5 years of age in Guinea-Bissau and investigate potential risk factor related to COVID-19 infection.

Methods This is a cross-sectional study, carried out in children under 5 years of age in the study area of the Bandim Health Project, a health and demographic surveillance system located in Guinea-Bissau, between April and July 2022. SARS-Cov-2 antibodies were investigated using rapid diagnostic tests (OnSite Rapid Test, CTK Biotech, USA) to determine the prevalence. Risk ratios (RR) were calculated with 95% confidence intervals using binomial regression.

Results The study included 831 children. The overall prevalence of SARS-Cov-2 antibodies was 51% (423/831). The prevalence was lowest among the youngest children aged 6–11 months. Older children had significant higher RRs, ranging from 1.47 (12 -23 months) to 1.80 (48–59 months). Other risk factors included whether the child had attended school/kindergarten: RR=1.33 (1.15–1.54); whether child had been ill during the pandemic: RR=1.22 (1.03–1.44); whether someone had died in the house, RR=1.40 (1.15–1.70) and children whose guardian (usually the mother) had attended school for more than five years, RR=1.49 (1.26–1.75).

Conclusion Confirmed cases of SARS-CoV-2 in Guinea-Bissau only represent about 0.5% of the population. However, this study indicates extensive circulation of SARS-CoV-2 since more than half of children under five year of age tested positive for SARS-CoV-2. Age of the child, deaths occurred in the house and education level of the guardian were all associated with previous SARS-CoV-2 infection.

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