Rubén Solano1, Inma Crespo2, María Isabel Fernández3, Carles Valero3, María Isabel Álvarez4, Pere Godoy5, Joan A Caylà6, Àngela Domínguez2. 1. CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain; Epidemiology Department, Barcelona Public Health Agency, Barcelona, Spain; Department of Public Health, University of Barcelona, Barcelona, Spain. Electronic address: rsolanosilveira@gmail.com. 2. CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain; Department of Public Health, University of Barcelona, Barcelona, Spain. 3. Evaluation and Quality Assessment Systems Unit, Primary Health Care Center, Catalan Institute of Health, Barcelona, Spain. 4. La Sagrera Primary Health Care Center, Catalan Institute of Health, Barcelona, Spain. 5. CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain; Public Health Agency of Catalonia, Barcelona, Spain. 6. CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain; Epidemiology Department, Barcelona Public Health Agency, Barcelona, Spain.
Abstract
BACKGROUND: Pertussis is an underestimated disease. Several European countries have developed models to account for underreporting of pertussis. The aim of this study was to estimate pertussis underdetection and underreporting in pediatric patients attending primary health care centers (PHCCs). METHODS: We reviewed clinical records of PHCCs in Barcelona in 2012. Factors associated with underdetection and underreporting were analyzed by logistic regression. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: We included 3,505 children aged < 7 years (mean age, 34 ± 20.7 months; range, 0-82 months) presenting with cough; 9.3% (326 out of 3,505) of patients also had ≥ 1 symptoms related to pertussis accompanied by cough for a duration ≥ 2 weeks. Of the 326 children receiving clinical criteria, only 31 (9.5%) were laboratory-confirmed and 6 (1.8%) were detected but not reported. There were 295 (90.5%) undetected suspected pertussis cases. Age ≥ 18 months (aOR, 8.51; 95% CI, 1.82-39.86), cyanosis (aOR, 6.71; 95% CI, 1.43-31.39), request for chest radiograph (aOR, 0.26; 95% CI, 0.07-0.99), and request for other laboratory tests (aOR, 5.39; 95% CI, 2.19-13.27) were associated with underdetection. Paroxysmal cough (aOR, 5.77; 95% CI, 1.05-31.76) and request for other laboratory tests (aOR, 2.91; 95% CI, 1.11-7.62) were associated with underreporting. CONCLUSIONS: Both underdetection and underreporting complicate the understanding of pertussis epidemiology. Correct assessment of pertussis symptoms and notification of cases must be improved to control pertussis.
BACKGROUND: Pertussis is an underestimated disease. Several European countries have developed models to account for underreporting of pertussis. The aim of this study was to estimate pertussis underdetection and underreporting in pediatric patients attending primary health care centers (PHCCs). METHODS: We reviewed clinical records of PHCCs in Barcelona in 2012. Factors associated with underdetection and underreporting were analyzed by logistic regression. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: We included 3,505 children aged < 7 years (mean age, 34 ± 20.7 months; range, 0-82 months) presenting with cough; 9.3% (326 out of 3,505) of patients also had ≥ 1 symptoms related to pertussis accompanied by cough for a duration ≥ 2 weeks. Of the 326 children receiving clinical criteria, only 31 (9.5%) were laboratory-confirmed and 6 (1.8%) were detected but not reported. There were 295 (90.5%) undetected suspected pertussis cases. Age ≥ 18 months (aOR, 8.51; 95% CI, 1.82-39.86), cyanosis (aOR, 6.71; 95% CI, 1.43-31.39), request for chest radiograph (aOR, 0.26; 95% CI, 0.07-0.99), and request for other laboratory tests (aOR, 5.39; 95% CI, 2.19-13.27) were associated with underdetection. Paroxysmal cough (aOR, 5.77; 95% CI, 1.05-31.76) and request for other laboratory tests (aOR, 2.91; 95% CI, 1.11-7.62) were associated with underreporting. CONCLUSIONS: Both underdetection and underreporting complicate the understanding of pertussis epidemiology. Correct assessment of pertussis symptoms and notification of cases must be improved to control pertussis.
Authors: Jeanne Heil; Henriëtte L G Ter Waarbeek; Christian J P A Hoebe; Peter H A Jacobs; Dirk W van Dam; Thera A M Trienekens; Jochen W L Cals; Inge H M van Loo; Nicole H T M Dukers-Muijrers Journal: Euro Surveill Date: 2017-07-13
Authors: Laura Iglesias; Antonio Casabella Pernas; Melisa Hernández Febles; Elena Colino Gil; Alicia Eisman Maraver; María José Pena López Journal: An Pediatr (Engl Ed) Date: 2017-12-06
Authors: Laura Iglesias; Antonio Casabella Pernas; Melisa Hernández Febles; Elena Colino Gil; Alicia Eisman Maraver; María José Pena López Journal: An Pediatr (Engl Ed) Date: 2018-07-21