Dataset Information

Global Childhood Deaths From Pertussis: A Historical Review.

ABSTRACT: Impact of pertussis vaccines on mortality is a key World Health Organization indicator, and trends in mortality rates and age distribution can inform maternal immunization strategies. We systematically reviewed studies reporting pertussis mortality rates (PMRs) per million population, identifying 19 eligible studies. During a prevaccine observation period of ?50 years in high-income countries (HICs), PMRs reduced in both infants and 1- to 4-year-olds by >80%, along with improvements in living conditions. In studies in low- and middle-income countries (LMICs), PMRs resembled highest prevaccine HIC rates. Postvaccine in HICs, significant further reduction in deaths (>98%) occurred, but with a large left shift in age of onset among residual deaths. Postvaccine in LMICs, limited data also show large and rapid decreases in PMRs, first in older infants and children, but long-term data fully enumerating residual deaths are lacking. In Sweden, large increases in the prevalence of undetectable pertussis antibodies were found at 10 years after high childhood coverage of acellular pertussis vaccines. Such data are not available from LMICs using whole-cell vaccines in a primary schedule without boosters. Data on residual infant deaths and maternal seroprevalence would be valuable inputs into consideration of pertussis vaccination in pregnancy in LMIC settings, especially if more precise immune correlates of infant protection against death from pertussis were known.

SUBMITTER: Chow MY

PROVIDER: S-EPMC5106618 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Global Childhood Deaths From Pertussis: A Historical Review.

Chow Maria Yui Kwan MY Khandaker Gulam G McIntyre Peter P

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20161201 suppl 4

Impact of pertussis vaccines on mortality is a key World Health Organization indicator, and trends in mortality rates and age distribution can inform maternal immunization strategies. We systematically reviewed studies reporting pertussis mortality rates (PMRs) per million population, identifying 19 eligible studies. During a prevaccine observation period of ≥50 years in high-income countries (HICs), PMRs reduced in both infants and 1- to 4-year-olds by >80%, along with improvements in living co ...[more]

PMID: 27838665

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Project description:BackgroundWorldwide, an estimated 5.1 million stillbirths and neonatal deaths occur annually, 98% in low- and middle-income countries. Limited coverage of civil and vital registration systems necessitates reliance on women's retrospective reporting in household surveys for data on these deaths. The predominant platform, Demographic and Health Surveys (DHS), has evolved over the last 35 years and differs by country, yet no previous study has described these differences and the effects of these changes on stillbirth and neonatal death measurement.MethodsWe undertook a review of DHS model questionnaires, protocols and methodological reports from DHS-I to DHS-VII, focusing on the collection of information on stillbirth and neonatal deaths describing differences in approaches, questionnaires and geographic reach up to December 9, 2019. We analysed the resultant data, applied previously used data quality criteria including ratios of stillbirth rate (SBR) to neonatal mortality rate (NMR) and early NMR (ENMR) to NMR, comparing by country, over time and by DHS module.ResultsDHS has conducted >320 surveys in 90 countries since 1984. Two types of maternity history have been used: full birth history (FBH) and full pregnancy history (FPH). A FBH collecting information only on live births has been included in all model questionnaires to date, with data on stillbirths collected through a reproductive calendar (DHS II-VI) or using additional questions on non-live births (DHS-VII). FPH collecting information on all pregnancies including live births, miscarriages, abortions and stillbirths has been used in 17 countries. We found no evidence of variation in stillbirth data quality assessed by SBR:NMR over time for FBH surveys with reproductive calendar, some variation for surveys with FBH in DHS-VII and most variation among the surveys conducted with a FPH. ENMR:NMR ratio increased over time, which may reflect changes in data quality or real epidemiological change.ConclusionDHS remains the major data source for pregnancy outcomes worldwide. Although the DHS model questionnaire has evolved over the last three and half decades, more robust evidence is required concerning optimal methods to obtain accurate data on stillbirths and neonatal deaths through household surveys and also to develop and test standardised data quality criteria.

Project description:Bordetella (B.) pertussis resurgence affects not only the unvaccinated, but also the vaccinated population. Different vaccines are available, however, it is currently unknown whether the type of childhood vaccination has an influence on antibody responses following a B. pertussis infection later in life. Therefore, the study aim was to profile serum antibody responses in young adults with suspected B. pertussis infections, immunized during childhood with either whole-cell (wPV) or monocomponent acellular pertussis (aPV) vaccines. Serum anti-pertussis toxin (PTx) IgG antibody levels served as an indicator for a recent B. pertussis infection. Leftover sera from a diagnostic laboratory from 36 Danish individuals were included and divided into four groups based on immunization background (aPV vs. wPV) and serum anti-PTx IgG levels (- vs. +). Pertussis-specific IgG/IgA antibody levels and antigen specificity were determined by using multiplex immunoassays (MIA), one- and two-dimensional immunoblotting (1 & 2DEWB), and mass spectrometry. Besides enhanced anti-PTx levels, wPV(+) and aPV(+) groups showed increased IgG and IgA levels against pertactin, filamentous hemagglutinin, fimbriae 2/3, and pertussis outer membrane vesicles (OMV). In the wPV(-) and aPV(-) groups, only low levels of anti-OMV antibodies were detected. 1DEWB demonstrated that antibody patterns differed between groups but also between individuals with the same immunization background and anti-PTx levels. 2DWB analysis for serum IgG revealed 133 immunogenic antigens of which 40 were significantly different between groups allowing to differentiate wPV(+) and aPV(+) groups. Similarly, for serum IgA, 7 of 47 immunogenic protein spots were significantly different. This study demonstrated that B. pertussis infection-induced antibody responses were distinct on antigen level between individuals with either wPV or aPV immunization background. Importantly, only 2DEWB and not MIA could detect these differences indicating the potential of this method. Moreover, in individuals immunized with an aPV containing only PTx in childhood, the infection-induced antibody responses were not limited to PTx alone.

Dataset Information

Global Childhood Deaths From Pertussis: A Historical Review.

Publications

Global Childhood Deaths From Pertussis: A Historical Review.

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