Incidence and Transmission Dynamics of <i>Bordetella pertussis</i> Infection in Rural and Urban Communities, South Africa, 2016‒2018

Moosa, Fathima; Tempia, Stefano; Kleynhans, Jackie; McMorrow, Meredith; Moyes, Jocelyn; Plessis, Mignon du; Carrim, Maimuna; Treurnicht, Florette K.; Helferscee, Orienka; Mkhencele, Thulisa; Mathunjwa, Azwifarwi; Martinson, Neil; Kahn, Kathleen; Lebina, Limakatso; Wafawanaka, Floidy; Cohen, Cheryl; Gottberg, Anne von; Wolter, Nicole

doi:10.3201/eid2902.221125

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…This issue of underestimation is also recognized in other countries. For example, a community cohort study in healthy people in South Africa estimated the incidence of pertussis at 0.21 per 100 person-weeks, higher than the previously reported mean annual incidence of 17 per 100,000 population in patients hospitalized for pneumonia [ 35 ]. To our knowledge, this is the first study in Latin America to estimate the underestimation rate for pertussis in adults aged 50 years or over based on a probabilistic model using data from literature and national surveillance systems.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Guzman-Holst,

Gomez,

Cintra

et al. 2023

Infect Dis Ther

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Introduction Pertussis, a contagious respiratory disease, is underreported in adults. The study objective was to quantify underestimation of pertussis cases in adults aged ≥ 50 years in five Latin American countries (Argentina, Brazil, Chile, Mexico, Peru). Methods A previously published probabilistic model was adapted to adjust the number of pertussis cases reported to national surveillance systems by successive multiplication steps (proportion of pertussis cases seeking healthcare; proportion with a specimen collected; proportion sent for confirmatory testing; proportion positive for pertussis; proportion reported to passive surveillance). The proportions at each step were added in a random effects model to produce a pooled overall proportion, and a final multiplier was calculated as the simple inverse of this proportion. This multiplier was applied to the number of cases reported to surveillance to estimate the number of pertussis cases. Monte Carlo simulation with 10,000 iterations estimated median as well as upper and lower 90% values. Input data were obtained from surveillance systems and published sources. Results The estimated median underestimation factor for pertussis cases in adults ranged from 104 (90% limits 40, 451) in Chile to 114 (90% limits 39, 419) in Argentina. In all five countries, the largest estimated number of cases was in the group aged 50–59 years. The highest number per 100,000 population was in the group aged ≥ 90 years in most countries. The estimated median underestimation factor for pertussis hospitalizations was 2.3 (90% limits 1.8, 3.3) in Brazil and 2.4 (90% limits 1.8, 3.2) in Chile (data not available for other countries). Conclusion This analysis indicates that the number of pertussis cases in adults aged ≥ 50 years in five Latin American countries is approximately 100 times higher than the number captured in surveillance data. These results could support decision-making in the diagnosis, management, and prevention of pertussis disease in adults.

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Section: Discussionmentioning

confidence: 99%

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Guzman-Holst,

Gomez,

Cintra

et al. 2023

Infect Dis Ther

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“…Pertussis disease caused by Bordetella pertussis is a public health concern in South Africa with peaks observed every 3-5 years [1][2][3]. Until the start of the coronavirus disease 2019 (COVID-19) pandemic, cases had continued to increase globally over the last 20 years, including in South Africa.…”

Section: Introductionmentioning

confidence: 99%

Genomic characterization of Bordetella pertussis in South Africa, 2015–2019

Moosa,

du Plessis,

Weigand

et al. 2023

Microbial Genomics

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Pertussis remains a public health concern in South Africa, with an increase in reported cases and outbreaks in recent years. Whole genome sequencing was performed on 32 Bordetella pertussis isolates sourced from three different surveillance programmes in South Africa between 2015 and 2019. Genome sequences were characterized using multilocus sequence typing, vaccine antigen genes (ptxP, ptxA, ptxB, prn and fimH) and overall genome structure. All isolates were sequence type 2 and harboured the pertussis toxin promoter allele ptxP3. The dominant genotype was ptxP3-ptxA1-ptxB2-prn2-fimH2 (31/32, 96.9 %), with no pertactin-deficient or other mutations in vaccine antigen genes identified. Amongst 21 isolates yielding closed genome assemblies, eight distinct genome structures were detected, with 61.9 % (13/21) of the isolates exhibiting three predominant structures. Increases in case numbers are probably not due to evolutionary changes in the genome but possibly due to other factors such as the cyclical nature of B. pertussis disease, waning immunity due to the use of acellular vaccines and/or population immunity gaps.

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Incidence and Transmission Dynamics of Bordetella pertussis Infection in Rural and Urban Communities, South Africa, 2016‒2018

Cited by 2 publications

References 16 publications

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Assessing the Underestimation of Adult Pertussis Disease in Five Latin American Countries

Genomic characterization of Bordetella pertussis in South Africa, 2015–2019

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