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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 5

Factors associated with household cumulative infection risk for 118 persons, PHIRST, South Africa, 2016–2018*

Characteristic
 B. pertussis HCIR, no. positive/no. tested (%)
 Univariate analysis
Multivariable analysis
Odds ratio (95% CI)
 p value
 Odds ratio (95% CI)
 p value
Characteristics of index case-patient
Sex
M 30/143 (20.9) 16.81 (1.43–197.69) 0.025 12.20 (1.57–94.96) 0.02
F 6/150 (4.0) Referent Referent
Age group, y
<5 2/43 (4.7) 0.05 (0.0003–7.40) 0.24 NA NA
5–14 27/182 (14.8) 0.38 (0.02–7.59) 0.53 NA NA
15–44 1/42 (2.4) 0.03 (0.0001–14.52) 0.27 NA NA
>45 6/22 (27.3) Referent NA NA
IS481 Ct category†
<34 16/57 (28.1) Referent NA NA
35–39 11/138 (7.9) 0.35 (0.02–6.17) 0.47 NA NA
40–44 9/98 (9.2) 0.43 (0.02–8.87) 0.59 NA NA
Episode duration, d
<7 12/216 (5.7) Referent Referent
>7
 24/77 (31.2)
 40.84 (3.37–495.19)
 0.004
24.79 (2.74–224.30)
 0.004
Characteristics of household contacts
Sex
M 15/110 (13.6) Referent NA NA
F 21/183 (11.5) 0.65 (0.22–1.93) 0.44 NA NA
Age group, y
<5 8/50 (16.0) 6.60 (1.22–35.64) 0.03 NA NA
5–14 11/88 (12.5) 2.10 (0.51–8.73) 0.31 NA NA
15–44 13/106 (12.3) 2.32 (0.30–17.76) 0.42 NA NA
>45 4/49 (8.20) Referent NA NA
HIV status
Negative 31/243 (12.8) Referent NA NA
Positive 5/44 (11.4) 1.27 (0.32–5.14) 0.73 NA NA
Unknown 0/6 (0.0) Referent NA NA NA
Nutritional status‡
Underweight 3/23 (13.0) 0.76 (0.08–6.95) 0.80 NA NA
Normal weight 21/160 (13.1) Referent NA NA
Overweight 11/107 (10.2) 0.76 (0.23–2.47) 0.65 NA NA
Underlying illness§
No 34/285 (11.9) Referent NA NA
Yes 2/8 (25.0) 16.93 (0.61–471.04) 0.09 NA NA
Crowding¶
No 8/100 (8.0) Referent NA NA
Yes 28/193 (14.5) 1.84 (0.21–16.42) 0.59 NA NA
Sleep in same room as index case-patient
No 24/158 (15.2) Referent NA NA
Yes 12/134 (8.9) 0.71 (0.22–2.26) 0.56 NA NA

*Bold indicates statistical significance. Variables adjusted for in final model: sex and episode duration. Ct, cycle threshold; HCIR, household cumulative infection risk; 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. †Used as a proxy for bacterial load. ‡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. ¶More than 2 persons in a household sleeping in the same room.

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Page created: November 23, 2022
Page updated: January 21, 2023
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