Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil.
Vaccine. 2021 Jan 3;39(1):137-146. doi: 10.1016/j.vaccine.2020.09.007.
Pertussis is associated with significant disease burden in children worldwide. In addition to its cyclical nature, resurgences of pertussis cases, hospitalizations and deaths have been reported by many countries. We describe the dynamics of pertussis in Brazil, a middle-income country that has experienced a resurgence and that provides good quality data to allow building a dynamic transmission disease model.
We conducted a descriptive analysis of pertussis burden considering data from the national disease surveillance system, national hospitalization information system and national mortality registry. Study period was 2000-2016. Absolute numbers and rates per 100,000 inhabitants over time, by age sub-groups and geographical regions are presented.
From 2000 to 2016, a total of 37,299 reported pertussis cases, 25,240 hospitalizations, and 601 deaths due to pertussis were reported. Although the outcomes - pertussis cases, hospitalizations, and deaths - come from independent information systems, our results document low disease burden with periodic increases every 3-4 years during the years 2000-2010, followed by a sharp increase which peaked in 2014. In both periods, disease burden is concentrated in young children, while its more serious outcomes - hospitalizations and deaths, are concentrated in infants. Pre-outbreak and outbreak disease burden as well as timing of peak during the outbreak period vary by states and within geographical regions, representing valuable resources of data for modelling purposes.
Consistent disease burden patterns were observed over time in Brazil using a variety of data sources. Given the scarcity of good epidemiological data on pertussis available from low- and middle-income countries, our reported data provide valuable information for the assessment of the public health impact and cost-effectiveness modelling studies of newer strategies to prevent and control pertussis. These data were used to build and calibrate a national dynamic transmission model, which was used to evaluate the cost-effectiveness of maternal immunization. Clinical Trial registry name and registration number: Not applicable.
百日咳在全球儿童中造成了重大疾病负担。除了周期性的特点外，许多国家还报告了百日咳病例的再次出现、住院和死亡。我们描述了巴西的百日咳动态，巴西是一个中等收入国家，经历了一次反弹，提供了高质量的数据，使建立动态传播疾病模型成为可能。
我们对国家疾病监测系统、国家住院信息系统和国家死亡登记处的数据进行了描述性分析，考虑了百日咳负担。研究时间为 2000-2016 年。按年龄亚组和地理区域展示了随时间变化的绝对数量和每 10 万人的发病率。
2000 年至 2016 年，共报告了 37299 例百日咳病例、25240 例住院病例和 601 例百日咳死亡病例。尽管这些结果-百日咳病例、住院病例和死亡病例-来自独立的信息系统，但我们的结果记录了发病率低的疾病负担，在 2000-2010 年期间每隔 3-4 年周期性增加，随后急剧增加，在 2014 年达到峰值。在这两个时期，疾病负担都集中在幼儿身上，而其更严重的后果-住院和死亡，则集中在婴儿身上。爆发前和爆发期间的疾病负担以及爆发期间的高峰期时间在各州和地理区域内有所不同，这为建模目的提供了有价值的数据资源。
巴西使用多种数据源观察到了随时间变化的一致的疾病负担模式。鉴于来自低收入和中等收入国家的百日咳的良好流行病学数据稀缺，我们报告的数据为评估公共卫生影响和成本效益建模研究提供了有价值的信息，这些数据用于建立和校准全国动态传播模型，该模型用于评估母亲免疫接种的成本效益。临床试验注册名称和注册号：不适用。
