ArticleThe Journal of infection2025
Bordetella pertussis infection and antibody dynamics in household cohorts in two South African communities, 2016 - 2018: findings from the PHIRST study.
Article in The Journal of infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
INTRODUCTION AND
methodsIn a cohort study, enrolling new households annually during 2016-2018, we estimated the B. pertussis attack rate using serology and PCR, identified factors associated with seroconversion, and described antibody changes over time. Nasopharyngeal swabs were collected biweekly for 6-10 months annually, with cases defined as individuals testing PCR-positive at least once. Seroconversion was defined as a ≥4-fold increase in anti-pertussis toxin IgG concentration between consecutive blood draws. Logistic regression was used to identify factors associated with seroconversion among PCR-positive individuals.
resultsAmong 1509 participants, the serology attack rate was 5.8% (87/1509), 6.2% (94/1509) by PCR, and 9.6% (145/1509) combining both methods. Among PCR-positive cases, 38.3% (36/94) seroconverted, with a mean time to seroconversion of 2.9 months (range: 3 weeks-5.9 months). Younger participants (5-18 years) (adjusted odds ratio (aOR) 6.8, 95% confidence interval (CI) 1.3-35.1) and those with episode durations of ≥7 days (aOR 13.3, 95% CI 3.4-51.1) were more likely to seroconvert. Among the seroconverted, 75.0% (27/36) maintained antibody concentrations >40 IU/ml for at least 12 months post-infection. DISCUSSION: Almost 10% of participants had B. pertussis infection during follow-up. Less than half of individuals with PCR-confirmed infection seroconverted but maintained elevated antibodies for at least one-year post-infection.
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