title: Pertussis prevalence and its determinants among children with persistent cough in urban Uganda.
abstract: BACKGROUND
  We determined prevalence of pertussis infection and its associated host and environmental factors to generate information that would guide strategies for disease control.
  
  
  METHODS
  In a cross-sectional study, 449 children aged 3 months to 12 years with persistent cough lasting ≥14 days were enrolled and evaluated for pertussis using DNA polymerase chain reaction (PCR) and ELISA serology tests.
  
  
  RESULTS
  Pertussis prevalence was 67 (15% (95% Confidence Interval (CI): 12-18)) and 81 (20% (95% CI: 16-24)) by PCR and ELISA, respectively among 449 participating children. The prevalence was highest in children with >59 months of age despite high vaccination coverage of 94% in this age group. Study demographic and clinical characteristics were similar between pertussis and non-pertussis cases. Of the 449 children, 133 (30%) had a coughing household member and 316 (70%) did not. Among 133 children that had a coughing household member, sex of child, sharing bed with a coughing household member and having a coughing individual in the neighborhood were factors associated with pertussis. Children that had shared a bed with a coughing household individual had seven-fold likelihood of having pertussis compared to children that did not (odds ratio (OR) 7.16 (95% CI: 1.24-41.44)). Among the 316 children that did not have a coughing household member, age <23 months, having or contact with a coughing individual in neighborhood, a residence with one room, and having a caretaker with >40 years of age were the factors associated with pertussis. Age <23months was three times more likely to be associated with pertussis compared to age 24-59 months (OR 2.97 (95% CI: 1.07-8.28)).
  
  
  CONCLUSIONS
  Findings suggest high prevalence of pertussis among children with persistent cough at a health facility and it was marked in children >59 months of age, suggesting the possibility of waning immunity. The factors associated with pertussis varied by presence or absence of a coughing household member.
authors: Department of Paediatrics & Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Vincent
authors: V
authors: Kayina
authors: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Samuel
authors: S
authors: Kyobe
authors: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Fred A
authors: FA
authors: Katabazi
authors: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Edgar
authors: E
authors: Kigozi
authors: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Moses
authors: M
authors: Okee
authors: Department of Paediatrics, School of Medicine, Gulu University, Gulu, Uganda.
authors: Beatrice
authors: B
authors: Odongkara
authors: Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Harriet M
authors: HM
authors: Babikako
authors: Department of Epidemiology & Biostatistics, College of Public Health, University of Georgia, Athens, United States of America.
authors: Christopher C
authors: CC
authors: Whalen
authors: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Moses L
authors: ML
authors: Joloba
authors: Department of Paediatrics & Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Philippa M
authors: PM
authors: Musoke
authors: Department of Paediatrics & Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
authors: Ezekiel
authors: E
authors: Mupere
mesh_terms: D000367:Age Factors; D001886:Bordetella pertussis / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D010567:Pertussis Vaccine / Q000008:administration & dosage*; D015995:Prevalence; D014454:Uganda; D014505:Urban Population; D014917:Whooping Cough / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*
chemical_list: D010567:Pertussis Vaccine