Display Pertussisin Pregnant Women in East Azerbaijan of Iran, Need to Improve Vaccination Strategies Volume 5 - Issue 5

Roqieh Babaei¹, Ali Badamchi², Hamide Hassanpour² and Jalal Shayegh*³

• ¹ Faculty of Biology, Ahar Branch, Islamic Azad University, Iran
• ²Children’s Medical Center Hospital, Tehran University of Medical SciencesTehran,Iran
• ³Department of Veterinary Medicine, Shabestar Branch, Islamic Azad University, Shabestar, Iran

Received: June 14, 2018;   Published: June 21, 2018

*Corresponding author: Jalal Shayegh, Department of Veterinary Medicine, Shabestar Branch, Islamic Azad University, Shabestar, Iran

DOI: 10.26717/BJSTR.2018.05.001278

Abstract PDF

Introduction: Pertussis, a respiratory infection caused by the bacteria Bordetella pertussis, can affect persons of any age, but it is particularly virulent and life-threatening in infants. Rates of pertussis infection have been increasing in recent years.

Methods: In this study, levels of IgG-PT and IgA-PT antibodies was analyzed in 349 serum samples obtained from pregnant women in east Azerbaijan (Tabriz city) using ELISA.

Results: Based on the results of ELISA, 56.2% of the serum samples had a protective level of IgG.

Conclusion: An outbreak among adults is a warning and risk factor for the development and spread of infection in newborns.

Keywords: Immunoglobulin Levels, Bordetella Pertussis, Pregnant Women, Iran

Pertussis is one of the vaccine-based preventable infectious diseases, worldwide. Before the onset of vaccination, the disease was a major contributor to mortality in infants and children [1]. Despite the high coverage of vaccination in different societies, recurrence of Pertussis has been reported in developed and either developing countries [2]. The agent for pertussis: Bordetella Pertussis, tend to be a human-specific pathogen that lacks animal reservoir and should inevitably spin among the human population. The disease is seen in children as a whooping cough, but it is often characterized by atypical and only with long cough in adults [3,4]. Recently, the decline in immunity due to the drop in antibody levels in adults increased the prevalence of the disease among adolescents and adults. Although, the disease does not have a clinical status in these hosts, such individuals are considered as the reservoir for the pathogen to be transmitted to the infants and young children [5].

On the other hand, passive immunity can occur through the transfer of antibodies made in maternal blood to the fetus through the placenta. This type of immunity can protect the infant for sev eral months after birth; drop in the level of immunity in mothers will reduce the transmission of maternal protective antibodies to infants and leave them sensitive until they receive the vaccine. However, this type of immunization cannot assure the immunization of the infants [6]. Securing mothers against diseases which are preventable by vaccines is essential to protect infants from 3 to 6 months, so the best way to protect infants during this period is to ensure that they receive enough maternal antibodies [7]. Low immunity levels in infants against B.pertussisis a sign of deficiency in maternal antibody, so immunization of booster in mothers during pregnancy can protect newborn babies a few months after birth [8]. Experts believe that to be immunized against Pertussis, adolescents and adults also require a boosting vaccine to reduce the infection and prevent further spread of the disease.

We have seen an increase in the incidence of the disease, which suggests that this is one of the world’s most recurrent diseases [9]. According to reports from the Center for Disease Control in Iran, the rate of disease has increased in recent years despite 98% vac- cine coverage [10,8]. Although several studies have been done on this disease and the level of safety in mothers, none of them included our study area. The study aimed to examine the prevalence of Pertussisanti bodies among pregnant women during pregnancy referring to Tabriz private laboratories, Northwest of Iran and one of the largest cities.

Ethics Statement: Informed consent was obtained from all study participants, and the Ethical Committee of the Islamic Azad University, Ahar, Iran approved the study. Serum samples: Samples in this study were serum samples of apparently healthy pregnant women referred to laboratories in Tabriz. They were selected, randomly. Samples were collected from April to September 2016 for 6 months. Information about age, occupation, history of coughing, education level, and pregnancy stage were obtained from each patient. Sample size was calculated based on previous studies. Serum samples were stored in a freezer at 80 °C . The serum sample of women with diabetes and a history of antibiotic use for several days prior to sampling were excluded from the study. Also samples that had hemolysis and serum samples with detectable chylomicrons were excluded.

Measurement of IgG and IgA by ELISA Method

Specific IgG and IgA antibody ELISA kit produced against Toxin produced by B.pertussisused in this study was prepared by IBL Co., (Immuno-Biological Laboratories, Hamburg, Germany). Each antibody was assessed according to the manufacturer’s instructions; and the results were recorded by drawing the graph for each of the immunoglobulins according to the factory’s instruction.

Statistical Analysis

Statistical analysis was performed using chi-square test between groups and ANOVA analysis to examine the relation between age, occupation, educational level, history of coughing and pregnancy stage. All analyzes were performed using SPSS version 24 and results were considered significant with P-value <0.5>

In this study, 349 serum samples were obtained from labs in Tabriz, whose pregnancy tests were reported positive. Data on the variables including age, occupation, history of coughing, education level and pregnancy stage are given in the following Table 1. Based on the results of ELISA, 196(56.2%) out of the 349 samples studied, had IgG with a protective level in the serum. The result was 21(6%) for IgA from the total 349 samples. About the relation between protective levels of antibody titers with age, occupation, history of coughing, education level, and pregnancy stage, there was a significant correlation between the protective levels of antibodies and the history of cough. Regarding other variables, the relation with the protective levels of antibodies was not significant (Table 1).

Table 1: Levels of IgG and IgA according to age, pregnancy stage, history of coughing, level of education and occupation (Tabriz, 2016).

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