The Cape Navigator

Young children in South Africa experience alarmingly high rates of infection-related hospitalization, primarily due to pneumonia. This is according to a new study by the University of Cape Town (UCT) and international scientists analyzing a South African birth cohort.

The study, part of the Drakenstein Child Health Study based in Paarl, monitored 1,225 children from before birth through their first two years of life. Even with high vaccination rates and no child HIV infections, researchers found that 28% of the children were hospitalized within those first two years.

Infections and Vulnerability

“Over 80% of hospital admissions were caused by an infection – pneumonia being the most common cause,” said Professor Heather Zar, lead investigator of the study. Respiratory syncytial virus (RSV) was a significant contributor, causing around a third of pneumonia cases and nearly a quarter of all hospitalizations within the first six months of life – the period of highest vulnerability.

HIV Impact Persists

Despite advances in antiretroviral therapy, the study highlighted that children who are HIV-exposed and uninfected (HEU) remain at increased risk. HEU children had double the risk of hospitalization in their first year and longer hospital stays. Maternal HIV viral load was a key factor in this risk.

“Children who are HEU appear to be at particular risk in infancy. This suggests the importance of continuing efforts to prevent HIV in women and focusing on managing HIV well,” said Dr. Catherine Wedderburn, chief research officer in the Department of Paediatrics & Child Health.

Prevention is Key

The study underscored the protective benefits of breastfeeding, especially against gastroenteritis, and the importance of timely vaccinations. Prematurity remained a risk factor for hospitalization. The findings call for urgent strengthening of preventative strategies, such as:

• Promoting early, exclusive, and prolonged breastfeeding
• Ensuring on-time vaccinations
• Optimizing maternal HIV care
• Targeting support for at-risk children (premature or HEU)

Hope for the Future

Professor Zar also emphasizes the potential impact of new RSV interventions recently approved in high-income countries. Advocacy for wider access to RSV prevention, such as vaccines or monoclonal antibodies, could drastically reduce child hospitalizations in low- and middle-income countries.

Source