NDLI: Underdetection and underreporting of pertussis in children attended in primary health care centers: Do surveillance systems require improvement?

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Underdetection and underreporting of pertussis in children attended in primary health care centers: Do surveillance systems require improvement?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Solano, Rubén Crespo, Inma Fernández, María Isabel Valero, Carles Álvarez, María Isabel Godoy, Pere Caylà, Joan A. Domínguez, Àngela
Description	Author Affiliation: Solano R ( CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain); Crespo I ( CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain); Fernández MI ( Evaluation and Quality Assessment Systems Unit, Primary Health Care Center, Catalan Institute of Health, Barcelona, Spain.); Valero C ( Evaluation and Quality Assessment Systems Unit, Primary Health Care Center, Catalan Institute of Health, Barcelona, Spain.); Álvarez MI ( La Sagrera Primary Health Care Center, Catalan Institute of Health, Barcelona, Spain.); Godoy P ( CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain); Caylà JA ( CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, Spain); Domínguez À ( CIBER Epidemiology and Public Health, Carlos III Institute of Health, Madrid, 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.
File Format	HTM / HTML
ISSN	01966553
Issue Number	11
Journal	American Journal of Infection Control
Volume Number	44
e-ISSN	15273296
Language	English
Publisher	Elsevier
Publisher Date	2016-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Communicable Diseases
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Public Health, Environmental and Occupational Health Epidemiology Health Policy

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