African Children Vulnerabilities in COVID-19 Era: A Review

Sewanou Raymond Aigba, Olivia Paul, Marie Lamarque, Bira Sall


The pandemic of COVID-19 has spread from China to the whole world. Here we address the vulnerability of African children in the context of this health crisis. Based on medical, socio-economic and anthropological studies, we present a thematic review that examines the issue at three levels. Firstly, we address the question of the effect of the virus on children in regard to strategies implemented to limit its spread and the capacity of medical devices in Africa. Second, we address the issue of the additional disruptions that the virus could generate by infecting the parents or guardians of children who often find themselves subject to the disquietudes of an informal economy. Finally, we discuss the long-term effects of the crisis on children about food security issues, particularly in relation to overweight and obesity. Based on studies that have documented the long-term overweight risks that can occur due to school cessation as a result of lockdown measures, we provide strategies to address this emerging public health problem in Africa. We conclude the study by suggesting that all these forms of vulnerabilities remain proactive areas of work to better prepare Africa for future pandemics. (Afr J Reprod Health 2020 (Special Edition); 24[2]: 154-171).

Full Text:



Maffioli EM. How Is the World Responding to the

Novel Coronavirus Disease (COVID-19) Compared with the 2014 West African Ebola Epidemic? The Importance of China as a Player in the Global Economy. Am J Trop Med Hyg. 2020;102(5):924-925. doi:10.4269/ajtmh.20-0135

Makoni M. Africa prepares for coronavirus. Lancet

(London, England). 2020;395(10223):483. doi:10.1016/S0140-6736(20)30355-X

Wu Z and McGoogan JM. Characteristics of and

Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA - J Am Med Assoc. 2020;323(13):1239-1242. doi:10.1001/jama.2020.2648

Chang TH, Wu JL and Chang LY. Clinical

characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis. J Formos

Med Assoc. 2020;(xxxx). doi:10.1016/j.jfma.2020.04.007

Hopman J, Allegranzi B and Mehtar S. Managing

COVID-19 in Low- and Middle-Income Countries. JAMA. 2020;323(16):1549. doi:10.1001/jama.2020.4169

Touray S, Sanyang B, Zandrow G, Dibba F, Fadera K,

Kanteh E, Danso M, Sanyang LN, Njie M, Johnson G, Sanyang A and Touray A. An assessment of critical care capacity in the Gambia. J Crit Care. 2018;47:245-253. doi:10.1016/j.jcrc.2018.07.022

World Health Organization. Minimum Requirements for

Infection Prevention and Control. Geneva; 2019.

Mukunya D and Tumwine JK. Challenges of tackling

non COVID-19 emergencies during the unprecedent pandemic. 2020;20(1):19-20. doi:10.4314/ahs.v20i1.2

Mustafa F and Green R. The implications of COVID-19

for the children of Africa. South African Med J. 2020;110(6):14824. doi:10.7196/SAMJ.2020v110i6.14824

Rundle AG, Park Y, Herbstman JB, Kinsey EW and

Wang YC. COVID‐19–Related School Closings and Risk of Weight Gain Among Children. Obesity. 2020;28(6):1008-1009. doi:10.1002/oby.22813

Ahmed AE. Limited transmissibility of coronavirus

(SARS-1, MERS, and SARS-2) in certain regions of Africa. J Med Virol. 2020:0-1. doi:10.1002/jmv.25852

Nachega J, Seydi M and Zumla A. The Late Arrival of

Coronavirus Disease 2019 (COVID-19) in Africa: Mitigating Pan-continental Spread. Clin Infect Dis. 2020;2019(Xx):4-7. doi:10.1093/cid/ciaa353

Miller A, Reandelar MJ, Fasciglione K, Roumenova V,

Li Y and Otazu GH. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study. MedRxiv. 2020;53(9):1689-1699. doi:10.1101/2020.03.24.20042937

Dong E, Du H and Gardner L. An interactive web-based

dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20(5):533-534. doi:10.1016/S1473-3099(20)30120-1

Okonofua FE, Eimuhi KE and Omonkhua AA. COVID-

: Perspectives and Reflections from Africa. Afr J Reprod Health. 2020;24(1):10-11. doi:10.29063/ajrh2020/v24i1.1

Balogun JA. Lessons from the USA Delayed Response

to the COVID-19 Pandemic. Afr J Reprod Health. 2020;24(1):14-21. doi:10.29063/ajrh2020/v24i1.2

Rothe D. Ebola : beyond the health emergency.


Ahonsi B. A Research Agenda on the Sexual and

Reproductive Health Dimensions of the COVID-19 Pandemic in Africa. Afr J Reprod Health. 2020;24(1):22-25. doi:10.29063/ajrh2020/v24i1.3

Sahu KK, Lal A and Mishra AK. Latest updates on

COVID‐2019: A changing paradigm shift. J Med Virol. 2020;92(6):533-535. doi:10.1002/jmv.25760

Bhagwanjee S. Critical Care in Africa. Crit Care Clin.

;22(3):433-438. doi:10.1016/j.ccc.2006.03.008

Marshall JC, Bosco L, Adhikari NK, Connolly B, Diaz

JV, Dorman T, Fowler RA, Meyfroidt G, Nakagawa S, Pelosi P, Vincent J-L, Vollman K and Zimmerman J. What is an intensive care unit? A report of the task force of the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2017;37:270-276. doi:10.1016/j.jcrc.2016.07.015

Baker T, Khalid K, Acicbe O, McGloughlin S and Amin

P. Critical care of tropical disease in low income countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care. 2017;42:351-354. doi:10.1016/j.jcrc.2017.11.028

Murthy S, Leligdowicz A and Adhikari NKJ. Intensive

Care Unit Capacity in Low-Income Countries: A Systematic Review. Azevedo LCP, ed. PLoS One. 2015;10(1):e0116949. doi:10.1371/journal.pone.0116949

Agyeman AA, Laar A and Ofori-Asenso R. Will

COVID-19 be a litmus test for post-Ebola sub-Saharan Africa? J Med Virol. March 2020:0-2. doi:10.1002/jmv.25780

Okech UK and Chokwe T. The operational setup of

intensive care units in a low income country in East Africa. East Afr Med J. 2015;92(2):72-80.

Wallace DJ, Angus DC, Seymour CW, Barnato AE and

Kahn JM. Critical care bed growth in the United States: A comparison of regional and national trends. Am J Respir Crit Care Med. 2015;191(4):410-416. doi:10.1164/rccm.201409-1746OC

Gooch RA and Kahn JM. ICU Bed Supply, Utilization,

and Health Care Spending. JAMA. 2014;311(6):567. doi:10.1001/jama.2013.283800

Tabor SR. Community-Based Health Insurance and

Social Protection Policy. 2005;(0503):1-64. Content/pdfs/Papers/English/0503.pdf.

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z and Tong

S. Epidemiology of COVID-19 Among Children in China. Pediatrics. March 2020:e20200702. doi:10.1542/peds.2020-0702

Ludvigsson JF. Systematic review of COVID-19 in

children shows milder cases and a better prognosis than adults. Acta Paediatr Int J Paediatr. 2020:0-3. doi:10.1111/apa.15270

Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W,

Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S and Wong GWK. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1665. doi:10.1056/NEJMc2005073

Levin M. Childhood Multisystem Inflammatory

Syndrome — A New Challenge in the Pandemic. N Engl J Med. June 2020:NEJMe2023158. doi:10.1056/NEJMe2023158

WHO. Multisystem inflammatory syndrome in children

and adolescents with COVID-19. 2020;(May):1-3.

Feldstein LR, Rose EB, Horwitz SM, Collins JP,

Newhams MM, Son MBF, Newburger JW, Kleinman LC, Heidemann SM, Martin AA, Singh AR, Li S, Tarquinio KM, Jaggi P, Oster ME, Zackai SP, Gillen J, Ratner AJ, Walsh RF, Fitzgerald JC, Keenaghan MA, Alharash H, Doymaz S, Clouser KN, Giuliano JS, Gupta A, Parker RM, Maddux AB, Havalad V, Ramsingh S, Bukulmez H, Bradford TT, Smith LS, Tenforde MW, Carroll CL, Riggs BJ, Gertz SJ, Daube A, Lansell A, Coronado Munoz A, Hobbs CV, Marohn KL, Halasa NB, Patel MM and Randolph AG. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. June 2020:NEJMoa2021680. doi:10.1056/NEJMoa2021680

Dufort EM, Koumans EH, Chow EJ, Rosenthal EM,

Muse A, Rowlands J, Barranco MA, Maxted AM, Rosenberg ES, Easton D, Udo T, Kumar J, Pulver W, Smith L, Hutton B, Blog D and Zucker H. Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. June 2020:NEJMoa2021756. doi:10.1056/NEJMoa2021756

Barral C, Bonnet D. Maladie de Kawasaki et

coronavirus : en moyenne “trois enfants par jour” hospitalisés à Necker. 05/05/2020. Published 2020. Accessed May 5, 2020.

Jones VG, Mills M, Suarez D, Hogan CA, Yeh D, Segal

JB, Nguyen EL, Barsh GR, Maskatia S and Mathew R. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020;10(6):537-540. doi:10.1542/hpeds.2020-0123

Rowley AH and Shulman ST. The Epidemiology and

Pathogenesis of Kawasaki Disease. Front Pediatr. 2018;6(December):1-4. doi:10.3389/fped.2018.00374

Rohner RP. Worldwide Tests of Parental Acceptance-

Rejection Theory: An Overview. Behav Sci Res. 1980;15(1):1-21. doi:10.1177/106939718001500102

Khaleque A and Rohner RP. Perceived Parental

Acceptance-Rejection and Psychological Adjustment: A Meta-Analysis of Cross-Cultural and Intracultural Studies. J Marriage Fam. 2002;64(1):54-64. doi:10.1111/j.1741-3737.2002.00054.x

McSherry D. Understanding and addressing the “neglect

of neglect”: Why are we making a mole-hill out of a mountain? Child Abuse Negl. 2007;31(6):607-614. doi:10.1016/j.chiabu.2006.08.011

Dubowitz H. Neglecting the Neglect of Neglect. J

Interpers Violence. 1994;9(4):556-560. doi:10.1177/088626094009004010

Dubowitz H. Understanding and addressing the “neglect

of neglect:” Digging into the molehill. Child Abuse Negl. 2007;31(6):603-606. doi:10.1016/j.chiabu.2007.04.002

Sullivan S. Child Neglect: Current Definitions and

Models A Review off Child Neglect Research, 1993–1998.; 2000.

Gaudin JM, Polansky NA, Kilpatrick AC and Shilton P.

Loneliness, depression, stress, and social supports in neglectful families. Am J Orthopsychiatry. 1993;63(4):597-605. doi:10.1037/h0079475

Rose SJ and Meezan W. Variations in Perceptions of

Child Neglect. Child Welfare. 1996;75(2):139-160.

Bronfenbrenner U. Making Human Beings Human:

Bioecological Perspectives on Human Development. Thousand Oaks,CA: Sage.; 2005.

Belsky J. Child maltreatment: An ecological integration.

Am Psychol. 1980;35(4):320-335. doi:10.1037/0003-066X.35.4.320

Garbarino J. The Human Ecology of Child

Maltreatment: A Conceptual Model for Research. J Marriage Fam. 1977;39(4):721. doi:10.2307/350477

Rose SJ and Meezan W. Defining Child Neglect:

Evolution, Influences, and Issues Social Service Review Defining Child Neglect: Evolution, Influences, and Issues. Source Soc Serv Rev. 1993;67(2):279-293.

Wolock I and Horowitz B. Child maltreatment as a

social problem: The neglect of neglect. Am J Orthopsychiatry. 1984;54(4):530-543. doi:10.1111/j.1939-0025.1984.tb01524.x

Tang CM. Working toward a conceptual definition of

child neglect. J Health Hum Serv Adm. 2008;31(3):356-384. doi:10.2307/41288094

Dubowitz H, Black M, Starr RH and Zuravin S. A

Conceptual Definition of Child Neglect. Crim Justice Behav. 1993;20(1):8-26. doi:10.1177/0093854893020001003

Polansky NA, Chalmos MA, Buttenweiser E and

Williams DP. Damaged Parents, Damaged Children: An Anatomy of Child Neglect. Univ Of Chicago Press; 1981.

Straus MA and Kantor GK. Definition and measurement

of neglectful behavior: Some principles and guidelines. Child Abus Negl. 2005;29(1):19-29. doi:10.1016/j.chiabu.2004.08.005

Korbin JE. Culture and Child Maltreatment. Child Abus

Negl. 2002;26:637-644. doi:10.1160/TH13-07-0566

De Bellis MD. The psychobiology of neglect. Child

Maltreat. 2005;10(2):150-172. doi:10.1177/1077559505275116

Barros M, Casimiro A, Cassamá AS, Mané C, Jau F and

Jorge Semedo R. State of “Emergency” for health but State of “Exception” for people: Guinea‐Bissau’s paradox in the battle against Covid‐19. City Soc. 2020;32(1):ciso.12262. doi:10.1111/ciso.12262

Rajaonah V. Réflexion sur I’éducation en Afrique.

Présence Africaine. 1979;111(3):19. doi:10.3917/presa.111.0019

Moumouni A. L’éducation En Afrique. Présence

africaine; 1998.

Winston CA. Self-Help for Grandmothers Parenting

Again. J Soc Distress Homeless. 1999;8(3):157-165. doi:10.1023/A:1021364625882

Foster G. The capacity of the extended family safety net

for orphans in Africa. Psychol Health Med. 2000;5(1):55-62. doi:10.1080/135485000106007

Chirwa WC. Social Exclusion and Inclusion: Challenges

to Orphan Care in Malawi. In: Nordic Journal of African Studies. Vol 11. New York, NY: Springer New York; 2002:93-113.

Meintjes H and Giese S. Spinning the Epidemic.

Childhood. 2006;13(3):407-430. doi:10.1177/0907568206066359

Oburu PO and Palmérus K. Parenting stress and self-

reported discipline strategies of Kenyan caregiving grandmothers. Int J Behav Dev. 2003;27(6):505-512. doi:10.1080/01650250344000127

Abebe T. Geographical dimensions of AIDS orphanhood

in sub-Saharan Africa. Nor Geogr Tidsskr - Nor J Geogr. 2005;59(1):37-47. doi:10.1080/00291950510020547

Abebe T and Skovdal M. Livelihoods, care and the

familial relations of orphans in eastern Africa. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2010;22(5):570-576. doi:10.1080/09540120903311474

Foster G. Supporting Community Efforts to Assist

Orphans in Africa. N Engl J Med. 2002;346(24):1907-1910. doi:10.1056/NEJMsb020718

Skovdal M and Campbell C. Orphan competent

communities: A framework for community analysis and action. Vulnerable Child Youth Stud. 2010;5(sup1):19-30. doi:10.1080/17450120903281173

World Vision. Violence against Children Affected by

HIV/AIDS: A Case Study of Uganda. 2005;(June). Against Children Affected by HIV-AIDS Uganda.pdf.

Foster G, Makufa C, Drew R, Mashumba S and Kambeu

S. Perceptions of children and community members concerning the circumstances of orphans in rural Zimbabwe. AIDS Care. 1997;9(4):391-405. doi:10.1080/713613166

Abebe T. Beyond the ‘Orphan Burden’: Understanding

Care for and by AIDS-affected Children in Africa. Geogr Compass. 2010;4(5):460-474. doi:10.1111/j.1749-8198.2009.00301.x

Hejoaka F. La concurrence des souffrances. Genèse et

usages électifs de la catégorie des orphelins et enfants vulnérables au temps du sida. Autrepart. 2014;72(4):59. doi:10.3917/autr.072.0059

Rodgers-Farmer AY. Parenting stress, depression, and

parenting in grandmothers raising their grandchildren. Child Youth Serv Rev. 1999;21(5):377-388. doi:10.1016/S0190-7409(99)00027-4

Kihato CW and Landau LB. Coercion or the social

contract? COVID 19 and spatial (in)justice in African cities. City Soc. 2020;n/a(n/a):ciso.12265. doi:10.1111/ciso.12265

Security N. Zimbabwe: Coronavirus Lockdown. Africa

Res Bull Polit Soc Cult Ser. 2020;57(3):22672A-22674C. doi:10.1111/j.1467-825X.2020.09393.x

Wang YC, Vine S, Hsiao A, Rundle A and Goldsmith J.

Weight-Related Behaviors When Children Are in School Versus on Summer Breaks: Does Income Matter? J Sch Health. 2015;85(7):458-466. doi:10.1111/josh.12274

Franckle R, Adler R and Davison K. Accelerated Weight

Gain Among Children During Summer Versus School Year and Related Racial/Ethnic Disparities: A Systematic Review. Prev Chronic Dis. 2014;11(12):130355. doi:10.5888/pcd11.130355

Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M,

Zoller T, Antoniazzi F, Piacentini G, Fearnbach SN and Heymsfield SB. Effects of COVID‐19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity. April 2020:oby.22861. doi:10.1002/oby.22861

Onywera VO. Childhood obesity and physical inactivity

threat in Africa: strategies for a healthy future. Glob Health Promot. 2010;17(2_suppl):45-46. doi:10.1177/1757975910363937

Akowuah PK and Kobia-Acquah E. Childhood Obesity

and Overweight in Ghana: A Systematic Review and Meta-Analysis. J Nutr Metab. 2020;2020. doi:10.1155/2020/1907416

von Hippel PT and Workman J. From Kindergarten

Through Second Grade, U.S. Children’s Obesity Prevalence Grows Only During Summer Vacations. Obesity. 2016;24(11):2296-2300. doi:10.1002/oby.21613

Rundle AG, Factor-Litvak P, Suglia SF, Susser ES,

Kezios KL, Lovasi GS, Cirillo PM, Cohn BA and Link BG. Tracking of Obesity in Childhood into Adulthood: Effects on Body Mass Index and Fat Mass Index at Age 50. Child Obes. 2020;16(3):226-233. doi:10.1089/chi.2019.0185

Comité de la Sécurité Alimentaire Mondiale. S’entendre

Sur La Terminologie : Sécurité Alimentaire, Sécurité Nutritionnelle, Sécurité Alimentaire et Nutrition, Sécurité Alimentaire et Nutritionnelle.; 2012.

Tougan UP and Théwis A. COVID‐19 et Sécurité

Alimentaire en Afrique Subsaharienne : Implications et Mesures Proactives d ’ Atténuation des Risques de Malnutrition et de Famine [ COVID‐19 and Food Security in Sub-Saharan Africa : Implications and Proactive Measures to Mitigate th. 2020.


  • There are currently no refbacks.