Koh M T, Liu C-S, Chiu C-H, Boonsawat W, Watanaveeradej V, Abdullah N, Zhang Xh, Devadiga R, Chen J
University of Malaya,Kuala Lumpur,Malaysia.
Family Medicine Department,China Medical University Hospital,Taichung,Taiwan.
Epidemiol Infect. 2016 Apr;144(6):1192-200. doi: 10.1017/S0950268815002393. Epub 2015 Oct 15.
Surveillance data on the burden of pertussis in Asian adults are limited. This cross-sectional study evaluated the prevalence of serologically confirmed pertussis in adults with prolonged cough in Malaysia, Taiwan and Thailand. Adults (⩾19 years) with cough lasting for ⩾14 days without other known underlying cause were enrolled from outpatient clinics of seven public and/or private hospitals. Single blood samples for anti-pertussis toxin antibodies (anti-PT IgG) were analysed and economic impact and health-related quality of life (EQ-5D) questionnaires assessed. Sixteen (5·13%) of the 312 chronically coughing adults had serological evidence of pertussis infection within the previous 12 months (anti-PT IgG titre ⩾62·5 IU/ml). Three of them were teachers. Longer duration of cough, paroxysms (75% seroconfirmed, 48% non-seroconfirmed) and breathlessness/chest pain (63% seroconfirmed, 36% non-seroconfirmed) were associated with pertussis (P < 0·04). Of the seroconfirmed patients, the median total direct medical cost per pertussis episode in public hospitals (including physician consultations and/or emergency room visits) was US$13 in Malaysia, US$83 in Taiwan (n = 1) and US$26 in Thailand. The overall median EQ-5D index score of cases was 0·72 (range 0·42-1·00). Pertussis should be considered in the aetiology of adults with a prolonged or paroxysmal cough, and vaccination programmes considered.
关于亚洲成年人百日咳负担的监测数据有限。这项横断面研究评估了马来西亚、台湾和泰国长期咳嗽的成年人中血清学确诊百日咳的患病率。从7家公立和/或私立医院的门诊招募了咳嗽持续≥14天且无其他已知潜在病因的成年人（≥19岁）。分析了抗百日咳毒素抗体（抗PT IgG）的单份血样，并评估了经济影响和健康相关生活质量（EQ-5D）问卷。312名慢性咳嗽成年人中有16名（5.13%）在过去12个月内有百日咳感染的血清学证据（抗PT IgG滴度≥62.5 IU/ml）。其中3人是教师。咳嗽持续时间较长、阵发性咳嗽（血清学确诊者占75%，未确诊者占48%）和呼吸急促/胸痛（血清学确诊者占63%，未确诊者占36%）与百日咳相关（P<0.04）。在血清学确诊的患者中，马来西亚公立医院每例百日咳发作的直接医疗总费用中位数为13美元，台湾为83美元（n=1），泰国为26美元。病例的EQ-5D指数总体中位数为0.72（范围0.42-1.00）。对于长期或阵发性咳嗽的成年人，病因应考虑百日咳，并考虑接种疫苗计划。
