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.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Solano R,Crespo I,Fernández MI,Valero C,Álvarez MI,Godoy P,Caylà JA,Domínguez Àdoi
10.1016/j.ajic.2016.03.033subject
Has Abstractpub_date
2016-11-01 00:00:00pages
e251-e256issue
11eissn
0196-6553issn
1527-3296pii
S0196-6553(16)30173-0journal_volume
44pub_type
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