학술논문
Pertussis-Associated Pneumonia in Infants and Children From Low- and Middle-Income Countries Participating in the PERCH Study.
Document Type
Academic Journal
Author
Barger-Kamate B; Department of Pediatrics, Division of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.; Spokane Emergency Physicians, Washington.; Deloria Knoll M; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Kagucia EW; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Prosperi C; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Baggett HC; Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi.; Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.; Brooks WA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab.; Feikin DR; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Division of Viral Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.; Hammitt LL; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi.; Howie SR; Medical Research Council Unit, Basse, The Gambia.; Department of Paediatrics, University of Auckland.; Centre for International Health, University of Otago, Dunedin, New Zealand.; Levine OS; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Bill & Melinda Gates Foundation, Seattle, Washington.; Madhi SA; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit.; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.; Scott JA; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi.; London School of Hygiene and Tropical Medicine, United Kingdom.; Thea DM; Center for Global Health and Development, Boston University School of Public Health, Massachusetts.; Amornintapichet T; Sa Kaeo Provincial Hospital, Thailand Ministry of Health, Sa Kaeo.; Anderson TP; Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand.; Awori JO; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi.; Baillie VL; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit.; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.; Chipeta J; Department of Paediatrics and Child Health, University of Zambia School of Medicine.; University Teaching Hospital, Lusaka, Zambia.; DeLuca AN; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Department of Epidemiology.; Driscoll AJ; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Goswami D; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab.; Higdon MM; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Hossain L; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka and Matlab.; Karron RA; Department of International Health, Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Maloney S; Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi.; Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.; Moore DP; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit.; Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases Unit, University of the Witwatersrand, Johannesburg, South Africa.; Morpeth SC; Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi.; London School of Hygiene and Tropical Medicine, United Kingdom.; Microbiology Laboratory, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.; Mwananyanda L; Center for Global Health and Development, Boston University School of Public Health, Massachusetts.; University Teaching Hospital, Lusaka, Zambia.; Ofordile O; Medical Research Council Unit, Basse, The Gambia.; Olutunde E; Medical Research Council Unit, Basse, The Gambia.; Park DE; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, George Washington University, Washington D.C.; Sow SO; Centre pour le Développement des Vaccins, Bamako, Mali.; Tapia MD; Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, Institute of Global Health, University of Maryland School of Medicine, Baltimore.; Murdoch DR; Microbiology Unit, Canterbury Health Laboratories, Christchurch, New Zealand.; Department of Pathology, University of Otago, Christchurch, New Zealand.; O'Brien KL; Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.; Kotloff KL; Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, Institute of Global Health, University of Maryland School of Medicine, Baltimore.
Source
Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE
Subject
Language
English
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.
(© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.)
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.
(© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America.)