An outbreak of pertussis in Bloemfontein, South Africa, 2008–2009

Hallbauer, Ute; Goosen, Yolande; Pieters, Madeleine

doi:10.1080/20786204.2011.10874140

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Our study findings suggest that community acquired pertussis is prevalent among children that present with persistent cough despite the high pertussis vaccination coverage with three doses of whole cell vaccine in infancy; and in a program with no booster doses and no adolescent or adult vaccination schedules. These findings are consistent with the few studies that have demonstrated that pertussis is endemic with recurrent outbreaks and could be re-emerging in Africa [ 12 , 13 , 14 , 15 ]. Zouari A et al reported a pertussis prevalence of 20% using PCR [ 12 ] in 599 Tunisian hospitalized infants who were recruited between 2007 and 2011.…”

Section: Discussionsupporting

confidence: 92%

Pertussis Prevalence and Its Determinants among Children with Persistent Cough in Urban Uganda

et al. 2015

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BackgroundWe determined prevalence of pertussis infection and its associated host and environmental factors to generate information that would guide strategies for disease control.MethodsIn a cross-sectional study, 449 children aged 3 months to 12 years with persistent cough lasting ≥14 days were enrolled and evaluated for pertussis using DNA polymerase chain reaction (PCR) and ELISA serology tests.ResultsPertussis prevalence was 67 (15% (95% Confidence Interval (CI): 12–18)) and 81 (20% (95% CI: 16–24)) by PCR and ELISA, respectively among 449 participating children. The prevalence was highest in children with >59 months of age despite high vaccination coverage of 94% in this age group. Study demographic and clinical characteristics were similar between pertussis and non-pertussis cases. Of the 449 children, 133 (30%) had a coughing household member and 316 (70%) did not. Among 133 children that had a coughing household member, sex of child, sharing bed with a coughing household member and having a coughing individual in the neighborhood were factors associated with pertussis. Children that had shared a bed with a coughing household individual had seven-fold likelihood of having pertussis compared to children that did not (odds ratio (OR) 7.16 (95% CI: 1.24–41.44)). Among the 316 children that did not have a coughing household member, age <23 months, having or contact with a coughing individual in neighborhood, a residence with one room, and having a caretaker with >40 years of age were the factors associated with pertussis. Age <23months was three times more likely to be associated with pertussis compared to age 24–59 months (OR 2.97 (95% CI: 1.07–8.28)).ConclusionFindings suggest high prevalence of pertussis among children with persistent cough at a health facility and it was marked in children >59 months of age, suggesting the possibility of waning immunity. The factors associated with pertussis varied by presence or absence of a coughing household member.

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Section: Discussionsupporting

confidence: 92%

Pertussis Prevalence and Its Determinants among Children with Persistent Cough in Urban Uganda

et al. 2015

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“…The delay in notification of the outbreak in this study area indicates that there was a poor active disease surveillance system at the local and district level. In this study, only 13.4% of cases had received pertussis-containing vaccine which is much lower compared with findings from a similar study (66.7%) [20]. A possible reason might be that the health extension worker who is responsible for notification of outbreaks and providing routine immunization had been off work for almost a year.…”

Section: Discussioncontrasting

confidence: 83%

“…Moreover, the distance of the health facility from the community might have also hindered the community from seeking care at the nearest facility. Overall pertussis containing vaccination coverage reported from the district was 69.3% which is lower as compared with the coverage in a similar study (90%) [20]. In our study, only 8 (13.3%) and 4 (6.6%) vaccinated for the pertussis-containing vaccine of Penta 1 (given on 6 th week) and Penta 2 (given on 10 th week) respectively which is considerably lower in contrast with Amhara regions' vaccine coverage [21].…”

Section: Discussionmentioning

confidence: 55%

Pertussis outbreak investigation in Janamora district, Amhara Regional State, Ethiopia: a case-control study

Almaw¹,

Bizuneh²

2019

Pan Afr Med J

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IntroductionOn April 17/2017 Janamora district, Amhara regional state health officials reported an increasing number of people with a cough. The objectives of this study was to investigate the outbreak, describe risk factors and implement control measures.MethodsWe conducted a community based unmatched 1:1 case-control study April 22-May 10, 2017. We used a probable case definition (≥2 weeks cough with vomiting, apnea, or inspiratory whoop) to identify suspected pertussis cases. Neighbors of cases were considered as controls. We conducted a door-to-door active case search and reviewed medical records, assessed vaccination status by parental interview or vaccination card. We implemented multivariable logistic regression to identify independent factors associated with the outbreak.ResultsWe investigated 60 cases and 60 controls. Most (68.3%) of the cases were under the age of 15. The majority (86.6%) of pertussis suspected cases, and 83.4% controls had not received any pertussis vaccine. The overall attack rate was 0.13% and the case fatality rate was 3.3%. The age-specific attack rate for under-five children was 0.33%. Females were more likely to have pertussis (AOR: 2.91; 95% CI: 1.17-7.22), contact with pertussis suspected person (AOR: 6.29; 95% CI: 2.53-15.62) and living in a relatively poorly ventilated house (AOR: 3.01; 95% CI: 1.17-7.70) were also significant risk factors of pertussis.ConclusionWeak supplementary immunization activities might have contributed to the outbreak. Treating household contacts and integration of diagnostic laboratory test of pertussis into the local health system is of paramount importance to detect outbreaks early on.

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“…Hussey et al reported similar low levels of protective antibody responses (69.1%) following vaccination with the same Hib vaccine amongst South African infants at 18 weeks of age in an adjacent community. [38] A recent outbreak of pertussis in Bloemfontein, South Africa, confirms the need for better immunization practices and suggests that young children are vulnerable and can contribute to its spread [39].…”

Section: Discussionmentioning

confidence: 99%

Delayed BCG immunization does not alter antibody responses to EPI vaccines in HIV-exposed and -unexposed South African infants

Hesseling

Blakney

Jones

et al. 2016

Vaccine

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Background Bacille Calmette-Guérin (BCG) is routinely given at birth in tuberculosis-endemic settings due to its protective effect against disseminated tuberculosis in infants. BCG is however contraindicated in HIV-infected infants. We investigated whether delaying BCG vaccination to 14 weeks of age affected vaccine-induced antibody responses to Haemophilus influenza type b (Hib)-conjugate, pertussis, tetanus and Hepatitis B (HBV) vaccines, in HIV-exposed uninfected (HEU) andunexposed uninfected (HUU) infants. Methods Infants were randomized to receive BCG at birth or at 14 weeks of age. Blood was taken at 14, 24, and 52 weeks of age and analyzed for Hib, pertussis, tetanus and HBV specific antibodies. Results BCG was given either at birth (106 infants, 51 HEU) or at 14 weeks of age (74 infants, 50 HEU). The timing of BCG vaccination did not influence the antibody response to any antigen studied. However, in a non-randomised comparison, HEU infants had higher Hib antibody concentrations at weeks 14 and 24 (p=0.001 and <0.001 respectively) and pertussis at week 24 (p=0.003). Conversely, HEU infants had lower antibody concentrations to HBV at 14 and 52 weeks (p=0.032 and p=0.031) with no differences in tetanus titres.

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An outbreak of pertussis in Bloemfontein, South Africa, 2008–2009

Cited by 5 publications

References 24 publications

Pertussis Prevalence and Its Determinants among Children with Persistent Cough in Urban Uganda

Pertussis Prevalence and Its Determinants among Children with Persistent Cough in Urban Uganda

Pertussis outbreak investigation in Janamora district, Amhara Regional State, Ethiopia: a case-control study

Delayed BCG immunization does not alter antibody responses to EPI vaccines in HIV-exposed and -unexposed South African infants

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