Dataset Information

Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study.

ABSTRACT:

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 with World 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 stratum 1-5 months, 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 pertussis-negative 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/µL (aOR, 4.6), and to have lymphocyte counts >10 000 cells/µL (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.

SUBMITTER: Barger-Kamate B

PROVIDER: S-EPMC5106621 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study.

Barger-Kamate Breanna B Deloria Knoll Maria M Kagucia E Wangeci EW Prosperi Christine C Baggett Henry C HC Brooks W Abdullah WA Feikin Daniel R DR Hammitt Laura L LL Howie Stephen R C SR Levine Orin S OS Madhi Shabir A SA Scott J Anthony G JA Thea Donald M DM Amornintapichet Tussanee T Anderson Trevor P TP Awori Juliet O JO Baillie Vicky L VL Chipeta James J DeLuca Andrea N AN Driscoll Amanda J AJ Goswami Doli D Higdon Melissa M MM Hossain Lokman L Karron Ruth A RA Maloney Susan S Moore David P DP Morpeth Susan C SC Mwananyanda Lawrence L Ofordile Ogochukwu O Olutunde Emmanuel E Park Daniel E DE Sow Samba O SO Tapia Milagritos D MD Murdoch David R DR O'Brien Katherine L KL Kotloff Karen L KL

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

<h4>Background</h4> Few data exist describing pertussis epidemiology among infants and children in low- and middle-income countries to guide preventive strategies.<h4>Methods</h4> Children 1-59 months of age hospitalized with World 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 n ...[more]

PMID: 27838672

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Dataset Information

Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study.

Background

Methods

Results

Conclusions

Publications

Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study.

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