Pertussis in Low and Medium Income Countries: A Pragmatic Approach

Guiso, Nicole; Taieb, Fabien

doi:10.1007/5584_2019_409

Cited by 12 publications

(9 citation statements)

References 43 publications

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“…A review of data quality status and capacity to respond to outbreaks at the district level must urgently be undertaken. Other LMICs, especially those in Sub-Saharan Africa, should use the lessons from this outbreak to actively review their vaccination systems and promote contextually suitable ways of outbreak detection, diagnosis, management and responses to avert similar challenges [43].…”

Section: Discussionmentioning

confidence: 99%

Pertussis outbreak in southern Ethiopia: challenges of detection, management, and response

et al. 2020

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Background: Despite the availability of effective vaccines, pertussis remains endemic with high fatality rates in low and middle-income countries (LMIC). This study aims to describe an outbreak of pertussis in a health district of Ethiopia. The study highlights the challenges faced by the health system in identifying pertussis cases and appropriately responding to the outbreak at the district level. Methods: A descriptive cross-sectional study was conducted using data sourced from the District Public Health Emergency and Management (PHEM) surveillance service and outbreak management field reports. Stratified attack rates and fatality rates for pertussis are described. Systemic problems leading to the outbreak are explored and narrated. A modified CDC pertussis case definition was employed with a polymerase chain reaction used to confirm cases. Results: From September 2018 to January 2019, 1840 suspected, probable, and confirmed pertussis cases and six deaths were identified. Pertussis cases ranged from 1 month to 51 years in age. An outbreak occurred in 14 out of the 24 villages of Dara Malo district. The overall attack rate was 1708 per 100,000 population with a fatality rate of 3.3 per 1000 pertussis cases. The highest attack rate of 12,689/100,000 was seen in infants. Among confirmed, probable and suspected pertussis cases, only 41.1% had completed the three-dose pertussis vaccine's primary schedule. The household survey revealed a population coverage of 73.4 and 40.8% for Pentavalent vaccine dose one and three respectively. Investigations suggested the existence of a poor cold chain management system in the study area. Conclusions: There is an urgent need to build capacity to strengthen routine vaccination services and improve the maintenance of the vaccine cold chain. Other LMICs are urged to take lessons learned from this outbreak to strengthen their own vaccination programs and capacitate health workers to manage local outbreaks.

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Section: Discussionmentioning

confidence: 99%

Pertussis outbreak in southern Ethiopia: challenges of detection, management, and response

et al. 2020

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“…pertussis is still endemic and most recent estimates indicate that around 24 million cases and 160 000 deaths from pertussis still occurred in children younger than 5 years of age in 2014 around the world, despite high, although <90%, vaccine coverage [2,9]. However, surveillance of the disease is rarely implemented in LMIC and these numbers are probably underestimated [7].…”

Section: Introductionmentioning

confidence: 99%

Transversal sero-epidemiological study of Bordetella pertussis in Tehran, Iran

et al. 2020

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Objectives Pertussis remains endemic despite high vaccine coverage in infants and toddlers. Pertussis vaccines confer protection but immunity wanes overtime and boosters are needed in a lifetime. Iran, eligible for the Expanded Program on Immunization that includes the primary immunization, implemented two additional booster doses using a whole-cell vaccine (wPV) at 18 months-old and about 6 years-old. Duration of protection induced by the wPVs currently in use and their impact as preschool booster are not well documented. This study aimed at assessing vaccination compliance and at estimating the duration of protection conferred by vaccination with wPV in children aged < 15 years in Tehran, Iran. Methods Detailed information on vaccination history and capillary blood samples were obtained from 1047 children aged 3-15 years who completed the 3 doses-primary pertussis immunization, in Tehran. Anti-pertussis toxin IgG levels were quantified by ELISA. Results Compliance was very high with 93.3% of children who received the three primary and 1 st booster doses in a timely manner. Timeliness of the 2 nd booster was lower (63.3%). Rate of seropositive samples continuously and significantly increased from 1-2 to 5-6 years after 1 st booster attaining 30.4% of children exhibiting serological sign of recent contact with B. pertussis. Second booster dating back 1 or 2 years was associated with high antibody titers, which significantly decreased within 3 years from injection. Among children who received 2 nd booster injection more than 2 years before serum analysis, seroprevalence of pertussis infection was 8.4% and seropositivity rate was higher from the 10 years-old group.

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“…The overview data from EpiWATCH is not representative of the total prevalence and is an underestimate of the burden of disease and has a bias toward high income countries. While pertussis still occurs in LMIC, detection and surveillance methods might be lacking, but also other illnesses, such as measles, might have higher priority for the available resources within these countries [22][23][24][25][26]. However, using open source reporting provides early warnings of outbreaks, often as soon as the outbreak becomes known in the community.…”

Section: Discussionmentioning

confidence: 99%

Using open source data to estimate the global epidemiology of pertussis

et al. 2020

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Introduction: Pertussis is a highly infectious disease that remains endemic despite rising vaccination rates globally. Due to the lack of global surveillance data for pertussis, the unconventional use of open-source data gives a glimpse into global outbreaks, compensating for the lack of national reporting systems in some countries. The objective of the study is to describe the global reporting of pertussis through open source data. Methods: An open-source database, EpiWATCH was used to analyse global outbreaks of pertussis. Data was retrieved on pertussis and analysed on multiple epidemiological factors from 2016 to 2019. In addition, incidence rates were calculated for each country and compared to the World Health Organization's (WHO) public domain data on global reported cases. Results: A total of 96 reports were collected globally between the years 2016 to 2019. Of those reports, 95.8% (92/96) were from high-income countries. Data from the United States comprised 59.3% (57/96) of the total reports. In addition, prevalence rates were calculated for each country and compared to the WHO's public domain data on global reported cases. An outbreak report was identified in Papua New Guinea, which was not reported in the WHO's surveillance. Discussion: Open-source data gives insight and analysis on pertussis outbreaks globally, given there is no formal global surveillance system for pertussis. There is a bias toward reports from high income countries in open source data. However, the timeliness of reporting coupled with assisting countries with lacking national reporting systems are benefits of open source data.

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Pertussis in Low and Medium Income Countries: A Pragmatic Approach

Cited by 12 publications

References 43 publications

Pertussis outbreak in southern Ethiopia: challenges of detection, management, and response

Pertussis outbreak in southern Ethiopia: challenges of detection, management, and response

Transversal sero-epidemiological study of Bordetella pertussis in Tehran, Iran

Using open source data to estimate the global epidemiology of pertussis

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