Recherche Clinique (Clinical Research) - Prévalence du Covid-19 chez les jeunes enfants hospitalisés avec pneumonie sévère ou malnutrition aiguë sévère en Afrique sub-saharienne et Asie du Sud Est. A sub-study of TB SPEED SAM and TB SPEED Pneumonia. Prevalence of COVID-19 in young children hospitalized with severe pneumonia or severe acute malnutrition in Sub-Saharan Africa and South-East Asia.

Although data from China, Europe and US show that children are less affected by the COVID-19 pandemic than adults,we do not know what happens when the infection occurs in immunocompromised children. Malnutrition is common in low and moderate income countries and can be associated with other frequent co-morbidities like HIV infection and sickle cell disease. Severe pneumonia remains one of the main cause of death in young children living in these countries and is also the main clinical presentation of severe COVID-19 disease in children. The TB-Speed project offers a unique opportunity to identify sub-groups of children who may be particularly affected by the COVID-19 pandemic and to propose specific measures to reduce the impact of the SARS-Cov-2 infection in these groups of children. TB-Speed COVID is an ancillary study nested in two ongoing TB-Speed studies in 6 countries in Africa and Asia: the TB-Speed Pneumonia trial that evaluates the impact of systematic detection of tuberculosis on mortality among young children admitted with severe pneumonia, and the TB-Speed SAM study that is aiming to develop a tuberculosis diagnostic algorithm for hospitalized children with severe acute malnutrition (SAM). The TB-Speed COVID study will assess the prevalence of the COVID-19 in these two groups of children at admission and its impact on children's outcomes. The 1st study group will be children below 5 years old with diagnosis of severe pneumonia according to WHO, and the 2nd group will be children younger than 5 years old, hospitalized with severe acute malnutrition defined by either weight-for-height Z score < -3 standard deviation or mid-upper arm circumference < 115 mm or clinical signs of bilateral pitting oedema. After informed consent signed by parents or guardian, nasal swab and stool will be collected and sent to referral testing laboratories for real time PCR of SARS-Cov-2. Dried blood spot will be collected at enrolment and after 3 months in infected children to assess seroprevalence and seroconversion. Clinical, biological and chest-ray data will be extracted from the TB-Speed Pneumonia and SAM studies at enrolment and during follow-up. Consecutive children included in the 15 sites of the TB-Speed Pneumonia study across 6 countries (Cambodia, Cameroon, Cote d'Ivoire, Mozambique, Uganda, Zambia) and in the 3 sites of the TB-Speed SAM in Uganda and Zambia will be enrolled in the TB-Speed COVID study over a 6 months period. We expect enrolling 1000 children with severe pneumonia and 200 hospitalized children with severe acute malnutrition.