Epidemiology of pertussis in a West African community before and after introduction of a widespread vaccination program.
The control of pertussis remains a worldwide concern. Little has been documented about its epidemiology in Africa. The authors have studied pertussis in a prospective cohort of children in a rural West African community over a 13-year period comprising time before and after introduction of a vaccination program. Children under age 15 years who were residents of the Niakhar study area in Senegal were followed prospectively between January 1984 and December 1996 for the occurrence of pertussis. Morbidity and mortality rates were extremely high before the launch of immunization. Crude incidence was 183 per 1,000 child-years at risk under age 5 years, with a 2.8% case-fatality rate. After the introduction of the vaccination program, overall incidence dropped rapidly and dramatically-by 27% after 3 years and 46% after 6 years. The decline in incidence involved all age groups but was most substantial in the group under age 5 years and was particularly pronounced in unvaccinated infants. The median age of acquisition of the disease rose steadily with population vaccine coverage. This study shows the tremendous magnitude of the disease burden in children and the rapid decline after vaccination, and it suggests a strong herd-immunity effect.
Préziosi
Marie-Pierre
MP
Unité de Recherche sur les Maladies Infectieuses et Parasitaires, Institut de Recherche pour le Développement, Dakar, Senegal. mprezio@sph.emory.edu
Yam
Abdoulaye
A
Wassilak
Steven G F
SG
Chabirand
Laurence
L
Simaga
Aminata
A
Ndiaye
Malick
M
Dia
Marème
M
Dabis
François
F
Simondon
François
F
D000293:Adolescent; D001886:Bordetella pertussis / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000379:methods; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012675:Senegal / Q000453:epidemiology; D014917:Whooping Cough / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control
D015721:Diphtheria-Tetanus-Pertussis Vaccine