Abstract

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

Barger-Kamate B, Deloria Knoll M, Kagucia EW, Prosperi C, Baggett HC, Brooks WA, Feikin DR, Hammitt LL, Howie SR, Levine OS, Madhi SA, Scott JA, Thea DM, Amornintapichet T, Anderson TP, Awori JO, Baillie VL, Chipeta J, DeLuca AN, Driscoll AJ, Goswami D, Higdon MM, Hossain L, Karron RA, Maloney S, Moore DP, Morpeth SC, Mwananyanda L, Ofordile O, Olutunde E, Park DE, Sow SO, Tapia MD, Murdoch DR, O'Brien KL, Kotloff KL, Pneumonia Etiology Research for Child Health Study Group
Clin Infect Dis. 2016;63

Permenent descriptor

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 /=14 days (aOR, 6.3), to have leukocyte counts >20 000 cells/microL (aOR, 4.6), and to have lymphocyte counts >10 000 cells/microL (aOR, 7.2) (all P