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Volume 29, Number 2—February 2023
Research

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

Fahima MoosaComments to Author , Stefano Tempia, Jackie Kleynhans, Meredith McMorrow, Jocelyn Moyes, Mignon du Plessis, Maimuna Carrim, Florette K. Treurnicht, Orienka Helferscee, Thulisa Mkhencele, Azwifarwi Mathunjwa, Neil A. Martinson, Kathleen Kahn, Limakatso Lebina, Floidy Wafawanaka, Cheryl Cohen, Anne von Gottberg, Nicole Wolter, and for the PHIRST Group
Author affiliations: University of the Witwatersrand, Johannesburg, South Africa (F. Moosa, S. Tempia, J. Moyes, M. du Plessis, M. Carrim, O. Hellferscee, C. Cohen, A. von Gottberg, N. Wolter); National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg (F. Moosa, J. Kleynhans, J. Moyes, M. du Plessis, M. Carrim, F.K. Treurnicht, O. Hellferscee, T. Mkhencele, A. Mathunjwa, C. Cohen, A. von Gottberg, N. Wolter); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, M.L McMorrow); Johns Hopkins University, Baltimore, Maryland, USA (N.A. Martinson); National Research Foundation, Pretoria, South Africa (N.A. Martinson); South African Medical Research Council, Cape Town, South Africa (N.A. Martinson, K. Kahn, L. Lebina, K. Mothlaoleng, F. Wafawanaka, A. Mathee); North-West University, Potchefstroom, South Africa (S. Piketh)

Main Article

Table 3

Factors associated with PCR-positive Bordetella pertussis infection duration for 118 persons participants in the PHIRST study of respiratory infections, South Africa, 2016–2018*

Characteristic B. pertussis mean ± SD infection duration, d Univariate analysis
 Multivariable analysis
Hazard ratio (95% CI) p value Adjusted hazard ratio (95% CI) p value
Sex
M 11.9 ± 21.1 Referent NA NA
F
 14.1 ± 18.8
 0.77 (0.45–1.31)
 0.34
NA
 NA
Age group, y
<5 6.3 ± 6·2 1.87 (0.84–4.20) 0.13 2.20 (0.87–5.58) 0.09
5–14 12.3 ± 14.5 1.09 (0.59–2.02) 0.78 1.16 (0.58–2.33) 0.67
15–44 15.4 ± 20.8 1.16 (0.50–2.67) 0.73 2.07 (0.81–5.27) 0.13
>45
 22.4 ± 38.8
 Referent
Referent
HIV status
Uninfected 13.8 ± 20.7 Referent NA NA
Infected
 9.3 ± 10.2
 1.06 (0.50–2.26)
 0.88
NA
 NA
Nutritional status†
Underweight 4.4 ± 2.7 2.78 (0.98–8.00) 0.06 NA NA
Normal 13.0 ± 18.7 Referent NA NA
Overweight/obese
 16.2 ± 25.3
 0.44 (0.71–2.17)
 0.44
NA
 NA
Underlying illness‡
No 12.4 ± 18.7 Referent NA NA
Yes
 28.2 ± 34.9
 0.80 (0.27–2.33)
 0.68
NA
 NA
Pertussis vaccination§
Incomplete 3.0 ± 0.0 2.44 (0.33–17.82) 0.38 NA NA
Fully vaccinated 6.7 ± 6.6 Referent NA NA
Unknown
 14.4 ± 21.1
 0.63 (0.29–1.36)
 0.24
NA
 NA
Symptoms
None 9.3 ± 14.1 Referent Referent
1 22.2 ± 20.3 0.62 (0.19–2.04) 0.44 0.39 (0.18–1.62) 0.19
>2
11.1 ± 10.2
 0.38 (0.16–0.93)
 0.03
0.26 (0.8–0.67)
 0.006
IS481 Ct category¶
<34 17.0 ± 11.6 0.17 (0.06–0.45) <0.001 0.16 (0.06–0.44) 0.0001
35–39 13.5 ± 20.7 0.43 (0.24–0.76) 0.004 0.41 (0.22–0.74) 0.003
40–44 11.1 ± 20.7 Referent Referent

*Bold indicates statistical significance. Variables adjusted for in final model: age group, presence/absence of symptoms, and IS481 Ct category. Ct, cycle threshold; IS, insertion sequence; NA, not applicable; PHIRST, Prospective Household cohort study of Influenza, Respiratory Syncytial virus, and other respiratory pathogens community burden and Transmission dynamics in South Africa. †Nutritional status is based on a person’s body mass index (BMI). We defined BMI categories as follows: underweight, age <18 y weight for age or BMI <‒2 SDs World Health Organization (WHO) Child Growth Standards; age >18 y BMI <18.5 kg/m2; overweight, age <18 y BMI >+1 and ≤+2 SD of the WHO growth standards, age ≥18 y BMI ≥25 and <30kg/m2; obese, age <18 y BMI >+2 SD of WHO growth standards, age ≥18 y BMI >30 kg/m2. ‡Defined as self-reported history of asthma, lung disease, heart disease, stroke, spinal cord injury, epilepsy, organ transplant, immunosuppressive therapy, organ transplantation, cancer, liver disease, renal disease, or diabetes. §Collected only for children <5 y of age· Vaccine status calculate based on number of doses of vaccine received by age. ¶Used as a proxy for bacterial load.

Main Article

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Page updated: January 21, 2023
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