Global Childhood Deaths From Pertussis: A Historical Review
Clinical Infectious Diseases·
- DOI
- 10.1093/cid/ciw529
- PMID
- 27838665
- PMCID
- PMC5106618
- OpenAlex
- W2550291580
- Study type
- Meta-analysis
- Publisher
- Oxford University Press (OUP)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Mortality reduction is a key WHO vaccine impact indicator. The findings highlight gaps in long-term enumeration of residual infant deaths and maternal seroprevalence data, particularly in low- and middle-income countries considering maternal pertussis vaccination. More precise immune correlates of infant protection against death would strengthen program planning.
Structured evidence summary
Research question
This systematic review examined historical pertussis mortality rates and age distribution patterns to inform vaccine impact assessment and maternal immunization strategies.
Study design
Systematic review identifying 19 studies reporting pertussis mortality rates per million population, comparing prevaccine and postvaccine periods across high-income and low- and middle-income countries.
Population and setting
Studies included high-income countries with ≥50 years of prevaccine observation and low- and middle-income countries. Age groups examined were infants, children aged 1-4 years, and older age groups including 10-year follow-up data from Sweden.
Main findings
In high-income countries, prevaccine mortality rates declined by over 80% in infants and young children alongside improvements in living conditions. Postvaccine periods showed further reductions exceeding 98%, with a pronounced shift toward younger age at death among remaining cases. Limited data from low- and middle-income countries demonstrated large, rapid decreases in mortality rates, initially among older infants and children. Swedish data revealed increased prevalence of undetectable pertussis antibodies 10 years after high acellular vaccine coverage.
Public-health relevance
Mortality reduction is a key WHO vaccine impact indicator. The findings highlight gaps in long-term enumeration of residual infant deaths and maternal seroprevalence data, particularly in low- and middle-income countries considering maternal pertussis vaccination. More precise immune correlates of infant protection against death would strengthen program planning.
Important limitations
Long-term data fully enumerating residual deaths in low- and middle-income countries are lacking. Data on maternal seroprevalence and waning immunity in LMIC settings using whole-cell vaccines without boosters are not available. This summary relies on the supplied single-article abstract and metadata; interpretation for decision-making requires review of the original paper.
GIDS interpretation
The article is discoverable through classifier links to pertussis, vaccination, and surveillance topics, as well as diphtheria, tetanus, and Sweden. These links reflect the study's subject matter and do not indicate that real-time surveillance data confirm or prompt the findings.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.