Table 4

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

Fahima Moosa

, 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)

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Factors associated with symptomatic Bordetella pertussis infection for 107 persons participants in the PHIRST study of respiratory infections, South Africa, 2016–2018*

Characteristic	B. pertussis symptomatic, no. positive/no. tested (%)	Univariate analysis		Multivariable analysis
Characteristic	B. pertussis symptomatic, no. positive/no. tested (%)	Odds ratio (95% CI)	p value	Adjusted odds ratio (95% CI)	p value
Year
2016	6/33 (18.2)	Referent		NA	NA
2017	2/29 (31.0)	2.03 (0.62–6.62)	0.24	NA	NA
2018	19/56 (33.9)	2.31 (0.81–6.56)	0.12	NA	NA
Site
Rural	13/48 (27.1)	Referent		NA	NA
Urban	21/70 (30.0)	1.15 (0.51–2.61)	0.73	NA	NA
Sex
M	10/52 (19.2)	Referent		NA	NA
F	24/66 (36.4)	2.40 (1.02–5.63)	0.04	NA	NA
Age group, y
<5	4/20 (20.0)	0.25 (0.05–1.14)	0.07	0.33 (0.06–1.69)	0.18
5–14	15/56 (26.8)	0.37 (0.11–1.22)	0.10	0.41 (0.11–1.54)	0.19
15–44	8/28 (28.6)	0.40 (0.11–1.51)	0.18	0.28 (0.06–1.22)	0.09
>45	7/14 (50.0)	Referent		Referent
HIV status
Uninfected	28/104 (26.9)	Referent		Referent
Infected	6/12 (50.0)	2.71 (0.81–9.11)	0.11	3.37 (0.77–14.56)	0.10
Nutritional status†
Underweight	0/9 (0.0)	0.15 (0.01–2.65)	0.19	NA	NA
Normal	20/77 (25.9)	Referent		NA	NA
Overweight/obese	13/28 (46.4)	2.44 (1.00–5.93)	0.05	NA	NA
Underlying illness‡
No	31/112 (27.7)	Referent		NA	NA
Yes	3/6 (50.0)	2.61 (0.50–13.65)	0.26	NA	NA
Pertussis vaccination§
Incomplete	0/2 (0.0)	0.47 (0.02–11.81)	0.64	NA	NA
Fully vaccinated	4/14 (28.6)	Referent		NA	NA
Unknown	30/102 (29.4)	0.98 (0.30–3.20)	0.98	NA	NA
IS481 Ct category¶
<34	6/15 (40.0)	3.05 (0.82–11.38)	0.09	NA	NA
35–39	21/64 (32.8)	2.23 (0.85–5.89)	0.11	NA	NA
40–44	7/39 (17.9)	Referent		NA	NA
Episode duration, d
<7	14/75 (18.7)	Referent		Referent
>7	20/43 (46.5)	3.79 (1.64–8.73)	0.002	4.12 (1.70–9.98)	0.002
Smoking, >15 y of age
No	14/37 (37.8)	Referent		NA	NA
Yes	5/16 (31.3)	0.75 (0.21–2.60)	0.65	NA	NA

*Bold indicates statistical significance. Variables adjusted for in final model: age group, HIV status, and episode duration. 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.

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Page updated: January 21, 2023

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