Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers.
Asymptomatic Bordetella pertussis infections in a longitudinal cohort of young African infants and their mothers.
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DOI：
10.7554/elife.65663
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发表时间：
2021-06-07
期刊：
影响因子：
7.7
通讯作者：
Rohani P
中科院分区：
文献类型：
--
作者：
Gill CJ;Gunning CE;MacLeod WB;Mwananyanda L;Thea DM;Pieciak RC;Kwenda G;Mupila Z;Rohani P
最近百日咳在许多国家死灰复燃可能是由无症状感染引起的。大多数百日咳监测研究是横断面的，不能区分无症状感染和症状前感染。纵向监测可以克服这一障碍，提供更多关于人口水平百日咳真正负担的信息。在这里，我们分析了17,442鼻咽样本的纵向队列的1320赞比亚母亲/婴儿对。我们的分析有两个要素。首先，我们证明了IS 481 qPCR CT值的全范围可深入了解百日咳流行病学，显示随着时间的推移，在母亲/婴儿对内，以及与百日咳相关的低CT和高CT结果的一致性。其次，我们利用这些全范围qPCR数据来证明无症状百日咳的高发病率，包括婴儿。我们的研究结果表明，在这一人群中，百日咳感染的负担比我们预期的要大，并暴露了在传染病监测中基于阈值的qPCR结果解释的关键局限性。
Recent pertussis resurgence in numerous countries may be driven by asymptomatic infections. Most pertussis surveillance studies are cross-sectional and cannot distinguish asymptomatic from pre-symptomatic infections. Longitudinal surveillance could overcome this barrier, providing more information about the true burden of pertussis at the population level. Here we analyze 17,442 nasopharyngeal samples from a longitudinal cohort of 1320 Zambian mother/infant pairs. Our analysis has two elements. First, we demonstrate that the full range of IS481 qPCR CT values provides insight into pertussis epidemiology, showing concordance of low and high CT results over time, within mother/infant pairs, and in relation to symptomatology. Second, we exploit these full-range qPCR data to demonstrate a high incidence of asymptomatic pertussis, including among infants. Our results demonstrate a wider burden of pertussis infection than we anticipated in this population, and expose key limitations of threshold-based interpretation of qPCR results in infectious disease surveillance.