Seroprevalence of pertussis among healthcare workers: A cross-sectional study from Tunisia

Fraj, Ikram Ben; Smaoui, H.; Zghal, Maroua; Sassi, Orjouane; Guiso, Nicole; Kechrid, A.

doi:10.1016/j.vaccine.2018.11.023

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Studies in various countries have assessed pertussis seroprevalence in the general population of adults 40 years old (albeit not stratified by underlying conditions). The seroprevalence in our study was in line with these published estimates (at the higher end) [45][46][47][48][49][50][51][52][53][54]. Comparisons are however complicated by the fact that different assays, thresholds and units of measurement were used across studies, and that studies occurred in different time periods, age groups and settings.…”

Section: Discussionsupporting

confidence: 89%

Seroprevalence ofBordetella pertussisInfection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort

Wilkinson

Steen

Cheuvart

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Pertussis is underdiagnosed and underreported in adults and patients with underlying conditions. Patients with chronic obstructive pulmonary disease (COPD) may be at increased risk of severe pertussis. Understanding the true prevalence of pertussis infections in such patients is important. We therefore evaluated the seroprevalence of anti-pertussis toxin (PT) antibodies in a cohort of 40-85-year-old patients diagnosed with moderate, severe or very severe COPD enrolled (between June 2011 and June 2012) in the prospective, observational "Acute Exacerbation and Respiratory InfectionS in COPD" (AERIS; NCT01360398) study, conducted in England. Serum anti-PT antibodies were measured in 104 patients using an enzyme-linked immunosorbent assay on samples collected 12 months (M12) and 24 months (M24) after enrollment. Overall, 14/104 (13.5%) patients had anti-PT concentrations 50 IU/mL at M12 or M24, indicative of exposure to Bordetella pertussis during the preceding 2-3 years. Of these, 6/104 (5.8%) had anti-PT 70 IU/mL, of whom 3/104 (2.9%) had anti-PT 120 IU/mL, indicative of exposure within 12 and 6 months, respectively. These results show a high circulation of B. pertussis in 40-85-year-old patients with moderate, severe or very severe COPD in England between 2012 and 2014, and call for enhanced immunization to prevent pertussis infections in such patients.

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Section: Discussionsupporting

confidence: 89%

Seroprevalence ofBordetella pertussisInfection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort

Wilkinson

Steen

Cheuvart

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…There were five studies which reported epidemiology data for pertussis in Africa, namely Senegal [ 27 ], Tunisia [ 28 ], Algeria [ 29 ], Nigeria [ 30 ], and Uganda [ 31 ], and seven studies which reported sero-epidemiology in Senegal [ 32 ], Cameroon [ 33 ], South Africa [ 34 ], Tunisia [ 35 , 36 ], Morocco [ 37 , 38 ], and Gambia [ 39 ]. There were seven studies with mortality data including Nigeria [ 30 , 40 ], Ethiopia [ 41 ], Morocco [ 42 ], South Africa [ 43 , 44 ], and Senegal [ 27 ].…”

Section: Search Resultsmentioning

confidence: 99%

“…Despite the intention of including children aged up to 18 years, all of the children included were aged < 10 years, and of the confirmed cases, 95% were aged < 6 months, 1.6% aged 1–5 years, and 0.7% aged > 5–10 years [ 28 ]. A seroprevalence study among healthcare workers (HCWs) at the same children’s hospital during the same surveillance period confirmed that pertussis was circulating in hospital settings and affecting HCWs in close contact with infants [ 35 ]. Among 236 HCWs with a median age of 31 years, there were 27 cases (11.4%; 95% CI 7.4–15.5) with anti-PT IgG ≥ 40 IU/ml, with a mean age of 39.5 years.…”

Section: Search Resultsmentioning

confidence: 99%

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Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Africa

Macina

Evans²

2021

Infect Dis Ther

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The Global Pertussis Initiative recommends diphtheria-tetanus-pertussis (DTP3) vaccination of infants aged \ 1 year for all African countries, and recommends the vaccination of pregnant women as a primary prevention strategy. However, the role of older children and adults in the transmission of pertussis in Africa is not clear. A systematic search of MEDLINE, EMBASE, and BIOSIS was undertaken to identify studies published between 1 January 1990 and 17 June 2019, with information on pertussis epidemiology, burden of illness, and mortality in school-aged children, adolescents, and adults in Africa. Studies identified for inclusion were reviewed narratively because a statistical comparison was not possible because of the mix of methodologies used.Studies from North Africa (Morocco, Tunisia, and Algeria) reported that although DTP4 vaccine coverage is high, severe pertussis-related complications persist in young children, vaccine-acquired immunity wanes in adolescents, and household contacts are important transmitters of infection. A serosurvey in Gambia showed that 6% of the general population had pertussis antibody levels suggesting recent infection, and studies from Senegal showed that pertussis infection was endemic despite high DTP3 coverage. During a pertussis outbreak in Ethiopia, the case fatality rate was 3.7% overall, and 6.3% among children aged 5-9 years. In a case-surveillance study in South Africa, the incidence of pertussis among hospitalized children was 526/100,000, and infection rates were higher in HIV-exposed and -infected children compared with uninfected children. In conclusion, the highest burden of pertussis in Africa is among infants, and surveillance is lacking in many African countries meaning that the burden of pertussis among infants and infection rates among older children and adults are not well reported, and likely underestimated.

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“…Despite high-national vaccination coverage (98%), circulation of B. pertussis in Tunisian infants has been reported [ 9 , 10 ] and three epidemics have been observed respectively in 2009, 2014 [ 10 ] and 2018 (unpublished observations). Moreover, circulation of pertussis among healthcare workers has been recently reported in a seroepidemiological study [ 11 ]. However, little is known about pertussis seroprevalence among children and adolescents, who are a potential reservoir of the disease.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of Bordetella pertussis toxin antibodies in children and adolescents in Tunis, Tunisia

et al. 2019

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Pertussis remains a public health concern in most countries. This cross-sectional study aims to investigate the distribution of pertussis toxin antibodies (anti-PT IgG) in Tunisian children and adolescents aged 3–18 years, to define optimal age for booster vaccination. Anti-PT IgG concentrations of enrolled participants were measured using commercial enzyme-linked immunosorbent assay. Concentrations were classified as: indicative of current/recent infection if ⩾100 IU/ml, indicative of recent exposure to Bordetella pertussis within the last year if 40–100 IU/ml and less likely revealing a recent exposure to B. pertussis if <40 IU/ml. Between March and June 2018, a total of 304 participants (mean age: 9.3 years) were included in this study. Overall, 12.8% (95% confidence interval (CI) 9.1%–16.6%) were seropositive (IgG levels ⩾40 IU/ml). Among them, 14.7% (95% CI 2.3%–23.3%) had levels indicative of a current/recent infection. The multivariate Poisson regression analysis suggested associations between female gender, as well as age group 13–18 years and 3–5 years and higher anti-PT IgG concentrations. Our results are consistent with the notion that vaccine-induced immunity decline, as well as circulation of pertussis among school children and adolescents enables them to be reservoirs of infection and disease transmission to vulnerable infants. Booster dose of acellular pertussis vaccine for school entrants is therefore recommended.

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Seroprevalence of pertussis among healthcare workers: A cross-sectional study from Tunisia

Cited by 7 publications

References 20 publications

Seroprevalence ofBordetella pertussisInfection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort

Seroprevalence ofBordetella pertussisInfection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort

Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Africa

Seroprevalence of Bordetella pertussis toxin antibodies in children and adolescents in Tunis, Tunisia

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