Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia.
National Research and Innovation Agency (BRIN), Jakarta, Indonesia.
PLoS One. 2022 Apr 20;17(4):e0266033. doi: 10.1371/journal.pone.0266033. eCollection 2022.
Pertussis cases have been reported most frequently in developed countries, but they are predicted to be the most prevalent in developing countries. Indonesia, a developing country, routinely conducts case-based surveillance for pertussis. We reviewed the data on pertussis cases and close contacts based on clinical sample documents examined in the National Reference Laboratory for pertussis, Indonesia (2016-2020). Our objective was to analyze the laboratory and epidemiological aspects of pertussis cases and close contacts, particularly to evaluate the implementation of a 5-year case-based surveillance of pertussis in Indonesia. Data were collected from sample documents and annual laboratory reports between January 2016 and December 2020. We analyzed the proportion of pertussis cases and close contacts by geographic region, year, age, and sex. We used the χ2 test to correlate the laboratory and epidemiological data. In total, 274 clinical cases of pertussis and 491 close contacts were recorded in 15 provinces. The peak number of cases occurred in 2019, with a positivity rate (percentage of laboratory-confirmed cases) of 41.23% (47/114). Clinical cases were dominated by infants aged <1 year (55.5%), and 52.9% of them were aged <6 months. Similarly, 72.3% (68/94) of the laboratory-confirmed cases were infants. Both clinical cases and positivity rates tended to be higher in females (155 cases, 38.1%) than in males (119 cases, 29.4%). No confirmed cases were found in children aged ≥10 years, although positive results still occurred in close contact. Age-group and laboratory-confirmed cases were correlated (p = 0.00). Clinical and confirmed cases of pertussis occurred mostly in the early age group and may be lower in those aged ≥10 years, especially in confirmed cases. New policies are needed for pertussis prevention at an early age, as well as the application of serology tests to increase laboratory-confirmed cases in children aged ≥10 years.
百日咳病例在发达国家报告最为频繁，但预计在发展中国家最为普遍。印度尼西亚是一个发展中国家，常规开展基于病例的百日咳监测。我们回顾了 2016 年至 2020 年印度尼西亚国家百日咳参考实验室检查的临床样本文件中基于病例的百日咳病例和密切接触者的数据。我们的目的是分析百日咳病例和密切接触者的实验室和流行病学方面，特别是评估印度尼西亚开展为期 5 年的基于病例的百日咳监测的实施情况。数据来自 2016 年 1 月至 2020 年 12 月的样本文件和年度实验室报告。我们按地理区域、年份、年龄和性别分析了百日咳病例和密切接触者的比例。我们使用 χ2 检验对实验室和流行病学数据进行相关性分析。共记录了来自 15 个省份的 274 例临床百日咳病例和 491 例密切接触者。病例数峰值出现在 2019 年，阳性率（实验室确诊病例的百分比）为 41.23%（47/114）。临床病例主要由<1 岁的婴儿（55.5%）组成，其中 52.9%的婴儿<6 个月。同样，94 例实验室确诊病例中有 72.3%（68/94）为婴儿。女性（155 例，38.1%）的临床病例和阳性率均高于男性（119 例，29.4%）。≥10 岁的儿童未发现确诊病例，但密切接触者仍有阳性结果。年龄组和实验室确诊病例呈正相关（p=0.00）。临床和确诊的百日咳病例主要发生在年龄较小的组中，≥10 岁年龄组的病例可能较低，尤其是确诊病例。需要制定新的政策来预防儿童早期百日咳，以及应用血清学检测来增加≥10 岁儿童的实验室确诊病例。
