Pertussis prevalence and its determinants among children with persistent cough in urban Uganda
Vincent Kayina1, Samuel Kyobe2, Fred A Katabazi2
1Department of Paediatrics & Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Insights
Pertussis infection is common in children with persistent cough, especially older children, indicating waning immunity. Close household contact and living conditions are key risk factors for pertussis transmission.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Immunology
Background:
- Pertussis (whooping cough) remains a significant public health concern globally.
- Understanding its prevalence and transmission dynamics in pediatric populations is crucial for effective control strategies.
Purpose of the Study:
- To determine the prevalence of pertussis infection among children presenting with persistent cough.
- To identify host and environmental factors associated with pertussis in this cohort.
Main Methods:
- A cross-sectional study involving 449 children (3 months to 12 years) with cough lasting ≥14 days.
- Diagnostic methods included DNA polymerase chain reaction (PCR) and ELISA serology for pertussis detection.
Main Results:
- Pertussis prevalence was 15% (PCR) and 20% (ELISA).
- Prevalence was highest in children over 59 months, despite high vaccination rates, suggesting waning immunity.
- Factors like sharing a bed with a coughing household member (OR 7.16) and younger age (<23 months) (OR 2.97) were associated with pertussis.
Conclusions:
- High pertussis prevalence in children with persistent cough highlights the need for improved diagnostics and potentially booster vaccinations.
- Risk factors differ based on household exposure, emphasizing the importance of contact tracing and family health education.
Background:
We determined prevalence of pertussis infection and its associated host and environmental factors to generate information that would guide strategies for disease control.
Methods:
In 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.
Results:
Pertussis 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)).
Conclusion:
Findings 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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