Evidence of pertussis resurgence in Burkina Faso despite high vaccination coverage: an outbreak investigation in a rural health district
DOI:
https://doi.org/10.64707/revstss.v48i2.1851Keywords:
Whopping cough, Bordetella pertussis, Sub-Saharan AfricaAbstract
Background
In recent years, large scale outbreaks of pertussis have occurred in high-income countries, with however little information available in sub-Saharan Africa. This study reports findings from an investigation of a pertussis outbreak among schoolchildren in Burkina Faso.
Methods
A cross-sectional survey which enrolled patients with coughing episodes at a primary school in the Sapouy health district was conducted between December 2024 and March 2025. Included subjects sociodemographic and clinical data were collected via direct interview and their nasopharyngeal swabs were also collected for etiological analysis by multiplex rT-PCR using the commercially available Fast Track Diagnostic (FTD®) Respiratory Pathogens 33 multiplex test.
Results
Of 116 pertussis suspected cases, 17.24% (20/116) were laboratory confirmed with Bordetella pertussis infection. After adjustment with the sociodemographic and clinical characteristics the presence of fever or history of fever in the last 24 hours in patients with coughing episodes was the only factor independently associated with laboratory confirmed cases of Bordetella pertussis infection (adjusted OR = 3.1, [95% CI: 1.1 – 9.0], p=0.03). A positive association trend was also reported for patients with shortness of breath (aOR = 2.8, [95% CI: 0.9 – 8.9], p=0.09) and those with sore throat (aOR = 2.3, [95% CI: 0.8 – 6.9], p=0.09) without being statistically significant.
Conclusions
These data provide evidence of Bordetella pertussis resurgence among school children in Burkina Faso despite the high vaccination coverage, implying that immunity from childhood vaccination may not be lifelong. Booster vaccination for high-risk groups may be beneficial as a control strategy.
References
WHO. Pertussis. Geneva, World Health Organization. 2024. https://www.who.int/health-topics/pertussis#tab=tab_1. Accessed 5 Aug 2025.
Guiso N, Meade BD, Wirsing von König CH. Pertussis vaccines: The first hundred years. Vaccine. 2020;38:1271–6. DOI: https://doi.org/10.1016/j.vaccine.2019.11.022
Cherry JD. Historical Review Of Pertussis And The Classical Vaccine. J Infect Dis. 1996;174:S259–63. DOI: https://doi.org/10.1093/infdis/174.Supplement_3.S259
Wang S, Zhang S, Liu J. Resurgence of pertussis: Epidemiological trends, contributing factors, challenges, and recommendations for vaccination and surveillance. Hum Vaccin Immunother. 2025;21:2513729.
Frenkel LD. The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better? Allergy Asthma Proc. 2021 Sep 1;42:378. DOI: https://doi.org/10.2500/aap.2021.42.210065
Wang S, Zhang S, Liu J. Resurgence of pertussis: Epidemiological trends, contributing factors, challenges, and recommendations for vaccination and surveillance. Hum Vaccin Immunother. 2025;21:2513729. DOI: https://doi.org/10.1080/21645515.2025.2513729
Domenech de Cellès M, Rohani P. Pertussis vaccines, epidemiology and evolution. Nat Rev Microbiol. 2024;22:722–35. DOI: https://doi.org/10.1038/s41579-024-01064-8
Nunes A, Abreu A, Furtado B, Soares da Silva A, Coelho EB, de Barros ENC. Epidemiology of pertussis among adolescents, adults, and older adults in selected countries of Latin American: a systematic review. Hum Vaccin Immunother [Internet]. 2021;17:1733. DOI: https://doi.org/10.1080/21645515.2020.1827613
Safarchi A, Octavia S, Nikbin VS, Lotfi MN, Zahraei SM, Tay CY, et al. Genomic epidemiology of Iranian Bordetella pertussis: 50 years after the implementation of whole cell vaccine. Emerg Microbes Infect. 2019;8:1416. DOI: https://doi.org/10.1080/22221751.2019.1665479
Carriquiriborde F, Regidor V, Aispuro PM, Magali G, Bartel E, Bottero D, et al. Rare Detection of Bordetella pertussis Pertactin-Deficient Strains in Argentina. Emerg Infect Dis. 2019;25:2048. DOI: https://doi.org/10.3201/eid2511.190329
Liu Y, Yu D, Wang K, Ye Q. Global resurgence of pertussis: A perspective from China. J Infect. 2024;89: 106289 . DOI: https://doi.org/10.1016/j.jinf.2024.106289
Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, et al. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis. 2024;24:974–1002. DOI: https://doi.org/10.1016/S1473-3099(24)00176-2
Macina D, Evans KE. Bordetella pertussis in School-Age Children, Adolescents, and Adults: A Systematic Review of Epidemiology, Burden, and Mortality in Africa. Infect Dis Ther. 2021;10:1097. DOI: https://doi.org/10.1007/s40121-021-00442-6
Alhassan JAK, Wariri O, Onuwabuchi E, Mark G, Kwarshak Y, Dase E. Access to skilled attendant at birth and the coverage of the third dose of diphtheria-tetanus-pertussis vaccine across 14 West African countries – an equity analysis. Int J Equity Health. 2020;19:78. DOI: https://doi.org/10.1186/s12939-020-01204-5
Jean Simon D, Kondo Tokpovi VC, Dianou K, Okonji OC, Kiragu A, Olorunsaiye CZ, et al. Regional, subregional and country-level full vaccination coverage in children aged 12–23 months for 34 countries in sub-Saharan Africa: a global analysis using Demographic and Health Survey data. BMJ Glob Heal. 2025 Mar 15;10:18333. DOI: https://doi.org/10.1136/bmjgh-2024-018333
Kagoné M, Yé M, Nébié E, Sie A, Schoeps A, Becher H, et al. Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso. Glob Health Action. 2017;10:1399749. DOI: https://doi.org/10.1080/16549716.2017.1399749
WHO. Burkina Faso: WHO and UNICEF estimates of immunization coverage: 2023 revision. Geneva, World Health Organization. 2025. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://cdn.who.int/media/docs/default-source/country-profiles/immunization/2024-country-profiles/immunization-2024-bfa.pdf?sfvrsn=52920509_3&download=true. Accessed 4 Aug 2025.
Kaboré R, Nebié E, Sidibé A, Lohmann J, Brenner S, Badolo H, et al. Timely completion of childhood vaccination and its predictors in Burkina Faso. Vaccine. 2022 May 26;40:3356–65. DOI: https://doi.org/10.1016/j.vaccine.2022.04.057
Ilboudo AK, Cissé A, Savadogo M, Sana M, Gouba N, Sourabié Y, et al. Epidemiological investigation of a pertussis outbreak among schoolchildren in Burkina Faso, 2019. BMC Res Notes. 2025;18:60. DOI: https://doi.org/10.1186/s13104-025-07129-y
Cissé A, Milucky J, Ilboudo AK, Waller JL, Bicaba B, Medah I, et al. Comparison of performance between Fast Track Diagnostics Respiratory Kit and the CDC global reference laboratory for influenza rRT-PCR panel for detection of influenza A and influenza B. Influenza Other Respi Viruses. 2021;15:381–8. DOI: https://doi.org/10.1111/irv.12830
Scott S, Van Der Sande M, Faye-Joof T, Mendy M, Sanneh B, Barry Jallow F, et al. Seroprevalence of pertussis in the Gambia: Eevidence for continued circulation of bordetella pertussis despite high vaccination rates. Pediatr Infect Dis J. 2015;34:333–8. DOI: https://doi.org/10.1097/INF.0000000000000576
Touray E, Barrow A, Kinteh B, Badjie M, Nget M, Touray J, et al. Childhood vaccination uptake and associated factors among children 12–23 months in rural settings of the Gambia: a community-based cross-sectional study. BMC Public Health. 2021;21:1–10. DOI: https://doi.org/10.1186/s12889-021-11810-9
Wariri O, Utazi CE, Okomo U, Sowe A, Sogur M, Fofanna S, et al. Impact of the COVID-19 pandemic on the coverage and timeliness of routine childhood vaccinations in the Gambia, 2015–2021. BMJ Glob Heal. 2023;8:14225. DOI: https://doi.org/10.1136/bmjgh-2023-014225
CDC. Pertussis Incidence by Age Group and Year (1990-2023. CDC 2025. https://www.cdc.gov/pertussis/php/surveillance/pertussis-incidence-by-age-group-and-year.html. Accessed 20 Sep 2025.
Liu Y, Ye Q. Resurgence and the shift in the age of peak onset of pertussis in southern China. J Infect. 2024;89:106194. DOI: https://doi.org/10.1016/j.jinf.2024.106194
CDC. Clinical Features of Pertussis (Whooping Cough) | CDC, 2024. https://www.cdc.gov/pertussis/hcp/clinical-signs/index.html. Accessed 20 Sep 2025.
Rodrigues C, Bouchez V, Soares A, Trombert-Paolanton S, El Belghiti FA, Cohen JF, et al. Resurgence of Bordetella pertussis, including one macrolide-resistant isolate, France, 2024. Euro Surveill. 2024;29: pii=2400459. DOI: https://doi.org/10.2807/1560-7917.ES.2024.29.31.2400459
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