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Epidemiology of pertussis in a West African community before and after introduction of a widespread vaccination

Marie-Pierre Préziosi1, Abdoulaye Yam, Steven G F Wassilak

  • 1Unité de Recherche sur les Maladies Infectieuses et Parasitaires, Institut de Recherche pour le Développement, Dakar, Senegal. mprezio@sph.emory.edu

American Journal of Epidemiology
|May 8, 2002
PubMed

Insights

Pertussis (whooping cough) control is vital. Vaccination dramatically reduced pertussis incidence and mortality in a West African cohort, demonstrating significant herd immunity.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Pertussis (whooping cough) control is a global health challenge.
  • Limited data exists on pertussis epidemiology in African communities.
  • High morbidity and mortality rates were observed prior to vaccination.

Purpose of the Study:

  • To investigate the epidemiology of pertussis in a rural West African community.
  • To assess the impact of a pertussis vaccination program on disease incidence and mortality.
  • To evaluate the potential for herd immunity in this population.

Main Methods:

  • Prospective cohort study of children under 15 years in Senegal (1984-1996).
  • Data collection on pertussis occurrence, morbidity, and mortality before and after vaccination introduction.
  • Analysis of incidence rates across different age groups and correlation with vaccine coverage.

Main Results:

  • Crude pertussis incidence was 183 per 1,000 child-years (under 5 years) with a 2.8% case-fatality rate before vaccination.
  • Vaccination led to a rapid and significant decline in incidence (27% by year 3, 46% by year 6).
  • Incidence reduction was most pronounced in children under 5 years and unvaccinated infants, with a rising median age of acquisition.

Conclusions:

  • Pertussis poses a substantial disease burden on children in this region.
  • Vaccination programs are highly effective in reducing pertussis incidence and mortality.
  • The study suggests a strong herd immunity effect following widespread vaccination.

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