Format

Send to

Choose Destination
BMC Pediatr. 2019 Nov 16;19(1):444. doi: 10.1186/s12887-019-1820-0.

The prevalence and clinical characteristics of pertussis-associated pneumonia among infants in Botswana.

Author information

1
Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. baburaya@bcchr.ubc.ca.
2
Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada. baburaya@bcchr.ubc.ca.
3
Division of Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
4
Botswana-University of Pennsylvania Partnership, Gaborone, Botswana.
5
Department of Pathology and Laboratory Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada.
6
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
7
Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
8
Global Health Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
9
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
10
Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA, USA.
11
Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, NC, USA.
12
Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
13
Department of Paediatrics and Adolescent Health, University of Botswana School of Medicine, Gaborone, Botswana.
14
Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.

Abstract

BACKGROUND:

There are scant data on the prevalence and clinical course of pertussis disease among infants with pneumonia in low- and middle-income countries. While pertussis vaccination coverage is high (≥90%) among infants in Botswana, human immunodeficiency virus (HIV) infection affects nearly one-third of pregnancies. We aimed to evaluate the prevalence and clinical course of pertussis disease in a cohort of HIV-unexposed uninfected (HUU), HIV-exposed uninfected (HEU), and HIV-infected infants with pneumonia in Botswana.

METHODS:

We recruited children 1-23 months of age with clinical pneumonia at a tertiary care hospital in Gaborone, Botswana between April 2012 and June 2016. We obtained nasopharyngeal swab specimens at enrollment and tested these samples using a previously validated in-house real-time PCR assay that detects a unique sequence of the porin gene of Bordetella pertussis.

RESULTS:

B. pertussis was identified in 1/248 (0.4%) HUU, 3/110 (2.7%) HEU, and 0/33 (0.0%) HIV-infected children. All pertussis-associated pneumonia cases occurred in infants 1-5 months of age (prevalence, 1.0% [1/103] in HUU and 4.8% [3/62] in HEU infants). No HEU infants with pertussis-associated pneumonia were taking cotrimoxazole prophylaxis at the time of hospital presentation. One HUU infant with pertussis-associated pneumonia required intensive care unit admission for mechanical ventilation, but there were no deaths.

CONCLUSIONS:

The prevalence of pertussis was low among infants and young children with pneumonia in Botswana. Although vaccination against pertussis in pregnancy is designed to prevent classical pertussis disease, reduction of pertussis-associated pneumonia might be an important additional benefit.

KEYWORDS:

Bordetella pertussis; HIV-exposed uninfected; Pneumonia

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center