{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T23:02:19Z","timestamp":1765839739986,"version":"3.48.0"},"reference-count":44,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,9,13]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (\u226418 years) seeking medical care, between 6 October and 16 November 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Research was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-051836","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T13:54:49Z","timestamp":1632232489000},"page":"e051836","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and risk factors for SARS-CoV-2 infection in children with and without symptoms seeking care in Managua, Nicaragua: results of a cross-sectional survey"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5259-8428","authenticated-orcid":false,"given":"Jorge A","family":"Huete-P\u00e9rez","sequence":"first","affiliation":[{"name":"Molecular Biology Center, Universidad Centroamericana, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kacey C","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, The University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiana","family":"Cabezas-Robelo","sequence":"additional","affiliation":[{"name":"Molecular Biology Center, Universidad Centroamericana, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"P\u00e1iz-Medina","sequence":"additional","affiliation":[{"name":"Molecular Biology Center, Universidad Centroamericana, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheyla","family":"Silva","sequence":"additional","affiliation":[{"name":"Pediatrics Unit, Vivian Pellas Hospital, Managua, Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra","family":"Huete","sequence":"additional","affiliation":[{"name":"Mount Auburn Hospital, Cambridge, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"key":"2025121514580834000_11.9.e051836.1","unstructured":"World Health Organization . 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