Under-recognized pertussis in adults from Asian countries: a cross-sectional seroprevalence study in Malaysia, Taiwan and Thailand

M T Koh, C-S Liu, C-H Chiu, W Boonsawat, V Watanaveeradej, N Abdullah, Xh Zhang, R Devadiga, J Chen, M T Koh, C-S Liu, C-H Chiu, W Boonsawat, V Watanaveeradej, N Abdullah, Xh Zhang, R Devadiga, J Chen

Abstract

Surveillance data on the burden of pertussis in Asian adults are limited. This cross-sectional study evaluated the prevalence of serologically confirmed pertussis in adults with prolonged cough in Malaysia, Taiwan and Thailand. Adults (⩾19 years) with cough lasting for ⩾14 days without other known underlying cause were enrolled from outpatient clinics of seven public and/or private hospitals. Single blood samples for anti-pertussis toxin antibodies (anti-PT IgG) were analysed and economic impact and health-related quality of life (EQ-5D) questionnaires assessed. Sixteen (5·13%) of the 312 chronically coughing adults had serological evidence of pertussis infection within the previous 12 months (anti-PT IgG titre ⩾62·5 IU/ml). Three of them were teachers. Longer duration of cough, paroxysms (75% seroconfirmed, 48% non-seroconfirmed) and breathlessness/chest pain (63% seroconfirmed, 36% non-seroconfirmed) were associated with pertussis (P < 0·04). Of the seroconfirmed patients, the median total direct medical cost per pertussis episode in public hospitals (including physician consultations and/or emergency room visits) was US$13 in Malaysia, US$83 in Taiwan (n = 1) and US$26 in Thailand. The overall median EQ-5D index score of cases was 0·72 (range 0·42-1·00). Pertussis should be considered in the aetiology of adults with a prolonged or paroxysmal cough, and vaccination programmes considered.

Trial registration: ClinicalTrials.gov NCT01597687.

Keywords: Bordetella pertussis; epidemiology; infectious disease epidemiology; pertussis (whooping cough); public health.

Figures

Fig. 1.
Fig. 1.
Flow of study subjects and serological results.
Fig. 2.
Fig. 2.
Proportion of subjects in each age group with serological evidence of pertussis in the previous 12 months (anti-PT IgG ⩾62·5 IU/ml; according-to-protocol cohort).
Fig. 3.
Fig. 3.
Distribution of anti-PT IgG concentrations by (a) age and (b) cough duration (according-to-protocol cohort).

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Source: PubMed

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