Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study
Background. Few data exist describing pertussis epidemiology among infants and children in low-and middle-income countries to guide preventive strategies. Methods. Children 1-59 months of age hospitalized withWorld Health Organization-defined severe or very severe pneumonia in 7 African and Asian co...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
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Oxford University Press
2016
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| _version_ | 1826296485420990464 |
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| author | Barger-Kamate, B Knoll, M Kagucia, EW Prosperi, C Baggett, HC Brooks, WA Feikin, DR Hammitt, LL Howie, SRC Levine, OS Madhi, SA Scott, JAG Thea, DM Amornintapichet, T Anderson, TP Awori, JO Baillie, VL Chipeta, J DeLuca, AN Driscoll, AJ Goswami, D Higdon, MM Hossain, L Karron, RA Maloney, S Moore, DP Morpeth, SC Mwananyanda, L Ofordile, O Olutunde, E Park, DE Sow, SO Tapia, MD Murdoch, DR O'Brien, KL Kotloff, KL |
| author_facet | Barger-Kamate, B Knoll, M Kagucia, EW Prosperi, C Baggett, HC Brooks, WA Feikin, DR Hammitt, LL Howie, SRC Levine, OS Madhi, SA Scott, JAG Thea, DM Amornintapichet, T Anderson, TP Awori, JO Baillie, VL Chipeta, J DeLuca, AN Driscoll, AJ Goswami, D Higdon, MM Hossain, L Karron, RA Maloney, S Moore, DP Morpeth, SC Mwananyanda, L Ofordile, O Olutunde, E Park, DE Sow, SO Tapia, MD Murdoch, DR O'Brien, KL Kotloff, KL |
| author_sort | Barger-Kamate, B |
| collection | OXFORD |
| description | Background. Few data exist describing pertussis epidemiology among infants and children in low-and middle-income countries to guide preventive strategies. Methods. Children 1-59 months of age hospitalized withWorld Health Organization-defined severe or very severe pneumonia in 7 African and Asian countries and similarly aged community controls were enrolled in the Pneumonia Etiology Research for Child Health study. They underwent a standardized clinical evaluation and provided nasopharyngeal and oropharyngeal swabs and induced sputum (cases only) for Bordetella pertussis polymerase chain reaction. Risk factors and pertussis-associated clinical findings were identified. Results. Bordetella pertussis was detected in 53 of 4200 (1.3%) cases and 11 of 5196 (0.2%) controls. In the age stratum1-5months, 40 (2.3% of 1721) cases were positive, all from African sites, as were 8 (0.5% of 1617) controls. Pertussis-positive African cases 1-5 months old, compared to controls, were more often human immunodeficiency virus (HIV) uninfected-exposed (adjusted odds ratio [aOR], 2.2), unvaccinated (aOR, 3.7), underweight (aOR, 6.3), and too young to be immunized (aOR, 16.1) (all P ? .05). Compared with pertussisnegative African cases in this age group, pertussis-positive cases were younger, more likely to vomit (aOR, 2.6), to cough ?14 days (aOR, 6.3), to have leukocyte counts > 20 000 cells/?L (aOR, 4.6), and to have lymphocyte counts > 10 000 cells/?L (aOR, 7.2) (all P ? .05). The case fatality ratio of pertussis-infected pneumonia cases 1-5 months of age was 12.5% (95% confidence interval, 4.2%-26.8%; 5/40); pertussis was identified in 3.7% of 137 in-hospital deaths among African cases in this age group. Conclusions. In the postneonatal period, pertussis causes a small fraction of hospitalized pneumonia cases and deaths; however, case fatality is substantial. The propensity to infect unvaccinated infants and those at risk for insufficient immunity (too young to be vaccinated, premature, HIV-infected/exposed) suggests that the role for maternal vaccination should be considered along with efforts to reduce exposure to risk factors and to optimize childhood pertussis vaccination coverage. |
| first_indexed | 2024-03-07T04:17:04Z |
| format | Journal article |
| id | oxford-uuid:c9c03ab4-f636-4fea-a349-46b2e3f0aa9f |
| institution | University of Oxford |
| last_indexed | 2024-03-07T04:17:04Z |
| publishDate | 2016 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:c9c03ab4-f636-4fea-a349-46b2e3f0aa9f2022-03-27T07:01:54ZPertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c9c03ab4-f636-4fea-a349-46b2e3f0aa9fSymplectic Elements at OxfordOxford University Press2016Barger-Kamate, BKnoll, MKagucia, EWProsperi, CBaggett, HCBrooks, WAFeikin, DRHammitt, LLHowie, SRCLevine, OSMadhi, SAScott, JAGThea, DMAmornintapichet, TAnderson, TPAwori, JOBaillie, VLChipeta, JDeLuca, ANDriscoll, AJGoswami, DHigdon, MMHossain, LKarron, RAMaloney, SMoore, DPMorpeth, SCMwananyanda, LOfordile, OOlutunde, EPark, DESow, SOTapia, MDMurdoch, DRO'Brien, KLKotloff, KLBackground. Few data exist describing pertussis epidemiology among infants and children in low-and middle-income countries to guide preventive strategies. Methods. Children 1-59 months of age hospitalized withWorld Health Organization-defined severe or very severe pneumonia in 7 African and Asian countries and similarly aged community controls were enrolled in the Pneumonia Etiology Research for Child Health study. They underwent a standardized clinical evaluation and provided nasopharyngeal and oropharyngeal swabs and induced sputum (cases only) for Bordetella pertussis polymerase chain reaction. Risk factors and pertussis-associated clinical findings were identified. Results. Bordetella pertussis was detected in 53 of 4200 (1.3%) cases and 11 of 5196 (0.2%) controls. In the age stratum1-5months, 40 (2.3% of 1721) cases were positive, all from African sites, as were 8 (0.5% of 1617) controls. Pertussis-positive African cases 1-5 months old, compared to controls, were more often human immunodeficiency virus (HIV) uninfected-exposed (adjusted odds ratio [aOR], 2.2), unvaccinated (aOR, 3.7), underweight (aOR, 6.3), and too young to be immunized (aOR, 16.1) (all P ? .05). Compared with pertussisnegative African cases in this age group, pertussis-positive cases were younger, more likely to vomit (aOR, 2.6), to cough ?14 days (aOR, 6.3), to have leukocyte counts > 20 000 cells/?L (aOR, 4.6), and to have lymphocyte counts > 10 000 cells/?L (aOR, 7.2) (all P ? .05). The case fatality ratio of pertussis-infected pneumonia cases 1-5 months of age was 12.5% (95% confidence interval, 4.2%-26.8%; 5/40); pertussis was identified in 3.7% of 137 in-hospital deaths among African cases in this age group. Conclusions. In the postneonatal period, pertussis causes a small fraction of hospitalized pneumonia cases and deaths; however, case fatality is substantial. The propensity to infect unvaccinated infants and those at risk for insufficient immunity (too young to be vaccinated, premature, HIV-infected/exposed) suggests that the role for maternal vaccination should be considered along with efforts to reduce exposure to risk factors and to optimize childhood pertussis vaccination coverage. |
| spellingShingle | Barger-Kamate, B Knoll, M Kagucia, EW Prosperi, C Baggett, HC Brooks, WA Feikin, DR Hammitt, LL Howie, SRC Levine, OS Madhi, SA Scott, JAG Thea, DM Amornintapichet, T Anderson, TP Awori, JO Baillie, VL Chipeta, J DeLuca, AN Driscoll, AJ Goswami, D Higdon, MM Hossain, L Karron, RA Maloney, S Moore, DP Morpeth, SC Mwananyanda, L Ofordile, O Olutunde, E Park, DE Sow, SO Tapia, MD Murdoch, DR O'Brien, KL Kotloff, KL Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title | Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title_full | Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title_fullStr | Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title_full_unstemmed | Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title_short | Pertussis-associated pneumonia in infants and children from low- and middle-income countries participating in the PERCH study |
| title_sort | pertussis associated pneumonia in infants and children from low and middle income countries participating in the perch study |
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