ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Incidence of Severe and Nonsevere Pertussis Among HIV-Exposed and -Unexposed Zambian Infants Through 14 Weeks of Age: Results From the Southern Africa Mother Infant Pertussis Study (SAMIPS), a Longitudinal Birth Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Variability in the Diagnostic Criteria for Severe Pertussis: A Systematic Review.JAMA network open · 2026Pooled it
- Pooled it
- The burden of vaccine-preventable diseases among HIV-infected and HIV-exposed children in sub-Saharan Africa: a systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2019Pooled it
- Longitudinal Analysis of Nasopharyngeal Microbial Risk Markers for Fatal Acute Febrile Illness in a Zambian Birth Cohort.The Journal of infectious diseases · 2025Article
- Risk of hospitalization or death does not differ in children exposed to HIV, yet uninfected compared to nonexposed peers in Lusaka, Zambia.AIDS (London, England) · 2025Article
- Clinical Characteristics and Real-World Drug Treatment of Severe Pertussis in Children: A Retrospective Study.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025Article
- Analysis of nasopharyngeal microbiome patterns in Zambian infants with fatal acute febrile illness.bioRxiv : the preprint server for biology · 2023Article
- Article
- Characterization of longitudinal nasopharyngeal microbiome patterns in maternally HIV-exposed Zambian infants.Gates open research · 2022Article
- Nasopharyngeal Dysbiosis Precedes the Development of Lower Respiratory Tract Infections in Young Infants, a Longitudinal Infant Cohort Study.Gates open research · 2022Article
- AsymptomaticeLife · 2021Observational
- Implementation and adherence of routine pertussis vaccination (DTP) in a low-resource urban birth cohort.BMJ open · 2020Article
- AsymptomaticmedRxiv : the preprint server for health sciences · 2020Article
- Article
- Clinical Characteristics of Hospitalized Infants With Laboratory-Confirmed Pertussis in Guatemala.Journal of the Pediatric Infectious Diseases Society · 2018Article
- Should equivocalCanada communicable disease report = Releve des maladies transmissibles au Canada · 2018Article
- Clinical characteristics of pediatric pertussis cases, Quebec 2015-2017.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2018Article
- Observational
- Assessing the Evidence for Maternal Pertussis Immunization: A Report From the Bill & Melinda Gates Foundation Symposium on Pertussis Infant Disease Burden in Low- and Lower-Middle-Income Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Review
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMaternal vaccination with tetanus, reduced-dose diphtheria, and acellular pertussis vaccine (Tdap) could be an effective way of mitigating the high residual burden of infant morbidity and mortality caused by Bordetella pertussis To better inform such interventions, we conducted a burden-of-disease study to determine the incidence of severe and nonsevere pertussis among a population of Zambian infants.
methodsMother-infant pairs were enrolled at 1 week of life, and then seen at 2- to 3-week intervals through 14 weeks of age. At each visit, nasopharyngeal (NP) swabs were obtained from both, and symptoms were catalogued. Using polymerase chain reaction (PCR) to identify cases, and a severity scoring system to triage these into severe/nonsevere, we calculated disease incidence using person-time at risk as the denominator.
resultsFrom a population of 1981 infants, we identified 10 with clinical pertussis, for an overall incidence of 2.4 cases (95% confidence interval [CI], 1.2-4.2) per 1000 infant-months and a cumulative incidence of 5.2 cases (95% CI, 2.6-9.0) per 1000 infants. Nine of 10 cases occurred within a 3-month window (May-July 2015), with highest incidence between birth and 6 weeks of age (3.5 cases per 1000 infant-months), concentrated among infants prior to vaccination or among those who had only received 1 dose of Diphtheria Tetanus whole cell Pertussis (DTwP). Maternal human immunodeficiency virus (HIV) modestly increased the risk of infant pertussis (risk ratio, 1.8 [95% CI, .5-6.9]). Only 1 of 10 infant cases qualified as having severe pertussis. The rest presented with the mild and nonspecific symptoms of cough, coryza, and/or tachypnea. Notably, cough durations were long, exceeding 30 days in several cases, with PCRs repeatedly positive over time.
conclusionsPertussis is circulating freely among this population of Zambian infants but rarely presents with the classical symptoms of paroxysmal cough, whooping, apnea, and cyanosis. Maternal HIV appears to increase the risk, while lack of effective exposure to DTwP increased the risk.
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