{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T21:45:39Z","timestamp":1787175939600,"version":"build-2736575974"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Pediatric Lassa fever (LF) usually presents as a nonspecific febrile illness, similar to other endemic diseases in countries like Sierra Leone, where LF is considered to be hyperendemic. The nonspecificity of presentation and lack of research have made it difficult to fully understand best practices for pediatric management. We aim to describe clinical characteristics of hospitalized pediatric patients suspected or diagnosed with LF and assess factors associated with hospital outcomes among those with LF antigen\u2013positive results. We conducted a 7-year retrospective cohort study using routine data for all children younger than 18 years admitted at the Kenema Government Hospital\u2019s LF ward. A total of 292 children with suspected or confirmed LF were analyzed. Overall, mortality was high (21%). Children with antigen-positive results had a high case fatality rate of 63% (<jats:italic>P<\/jats:italic> &lt; 0.01). In univariate analyses, children who presented with unexplained bleeding (odds ratio [OR]: 3.58; 95% CI: 1.08\u201311.86; <jats:italic>P<\/jats:italic> = 0.040) and confusion (altered sensorium) (OR: 5.37; 95% CI: 1.34\u201321.48; <jats:italic>P<\/jats:italic> = 0.020) had increased odds of death. Abnormal serum levels of alanine aminotransferase (<jats:italic>P<\/jats:italic> = 0.001), creatinine (<jats:italic>P<\/jats:italic> = 0.004), and potassium (<jats:italic>P<\/jats:italic> = 0.003) were associated with increased likelihood of death in these children. Treatment with ribavirin was not significantly associated with survival (<jats:italic>P<\/jats:italic> = 0.916). Our findings provide insights into current pediatric LF clinical presentation and management. More evidence-based, high-quality research in creating predictive algorithms of antigen-positivity and hospital outcomes is needed in the management of pediatric LF.<\/jats:p>","DOI":"10.4269\/ajtmh.20-0773","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T07:02:05Z","timestamp":1606201325000},"page":"585-592","source":"Crossref","is-referenced-by-count":23,"title":["Lassa Fever among Children in Eastern Province, Sierra Leone: A 7-year Retrospective Analysis (2012\u20132018)"],"prefix":"10.4269","volume":"104","author":[{"given":"Robert J.","family":"Samuels","sequence":"first","affiliation":[{"name":"1Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy D.","family":"Moon","sequence":"additional","affiliation":[{"name":"1Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Starnes","sequence":"additional","affiliation":[{"name":"1Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foday","family":"Alhasan","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gbakie","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustine","family":"Goba","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Koroma","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mambu","family":"Momoh","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Demby","family":"Sandi","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Garry","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"},{"name":"3Department of Immunology and Microbiology, School of Medicine, Tulane University, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Engel","sequence":"additional","affiliation":[{"name":"4Department of Pediatrics and Internal Medicine, Sections of Pediatric and Adult Infectious Diseases, School of Medicine, Tulane University, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey G.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"5Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John S.","family":"Schieffelin","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"},{"name":"4Department of Pediatrics and Internal Medicine, Sections of Pediatric and Adult Infectious Diseases, School of Medicine, Tulane University, New Orleans, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald S.","family":"Grant","sequence":"additional","affiliation":[{"name":"2Lassa Fever Program, Kenema Government Hospital, Ministry of Health and Sanitation, Kenema, Sierra Leone;"},{"name":"6College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/2\/article-p585.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/2\/article-p585.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T01:39:54Z","timestamp":1612834794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/2\/article-p585.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,3]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-0773","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,3]]}}}