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We investigated the first 152 laboratory-confirmed SARS-CoV-2 cases (125 primary and 27 secondary) and their 248 close contacts in Kisumu County, Kenya. Conducted June 10-October 8, 2020, this study included interviews and sample collection at enrolment and 14-21 days later. Median age was 35 years (IQR 28-44); 69.0% reported COVID-19 related symptoms, most commonly cough (60.0%), headache (55.2%), fever (53.3%) and loss of taste or smell (43.8%). One in five were hospitalized, 34.4% >25 years of age had at least one comorbidity, and all deaths had comorbidities. Adults ≥25 years with a comorbidity were 3.15 (95% CI 1.37-7.26) times more likely to have been hospitalized or died than participants without a comorbidity. Infectious comorbidities included HIV, tuberculosis, and malaria, but no current cases of influenza, respiratory syncytial virus, dengue fever, leptospirosis or chikungunya were identified. Thirteen (10.4%) of the 125 primary infections transmitted COVID-19 to 27 close contacts, 158 (63.7%) of whom resided or worked within the same household. Thirty-one percent (4 of 13) of those who transmitted COVID-19 to secondary cases were health care workers; no known secondary transmissions occurred between health care workers. This rapid assessment early in the course of the COVID-19 pandemic identified some context-specific characteristics which conflicted with the national line-listing of cases, and which have been substantiated in the year since. These included over two-thirds of cases reporting the development of symptoms during the two weeks after diagnosis, compared to the 7% of cases reported nationally; over half of cases reporting headaches, and nearly half of all cases reporting loss of taste and smell, none of which were reported at the time by the World Health Organization to be common symptoms. This study highlights the importance of rapid in-depth assessments of outbreaks in understanding the local epidemiology and response measures required.

Why you should read this article: • To refresh your knowledge of pubertal development in children • To identify the contributory factors for early, or precocious, puberty and how they may be prevented and managed • To recognise the role of nurses in supporting children experiencing precocious puberty and their families, with a focus on girls. Puberty is an important marker of health and development in a child’s life. Complex neuroendocrine factors contribute to the onset of puberty. While pubertal changes usually occur between the ages of 12 and 13 years, some children may attain puberty before the age of eight years for girls and nine years for boys, which is termed precocious puberty. A literature review was conducted to explore the incidence and prevalence of precocious puberty, identify contributory factors, and recognise management and preventive measures. In addition, the effects on the child and family and the role of nurses were considered. The incidence and prevalence of precocious puberty are increasing. Obesity, early childhood stressors, environmental toxins, increased access to the internet and socioeconomic status are contributory factors. Pharmacological and psychological interventions may be used to manage precocious puberty. Lifestyle modifications such as healthy eating are important preventive measures. Nurses have an important role in preparing children and families, and supporting their psychological and social well-being. [ABSTRACT FROM AUTHOR]