Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia.
Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia.
J Infect Dev Ctries. 2024 Sep 30;18(9):1394-1403. doi: 10.3855/jidc.18837.
A resurgence of pertussis has been reported in numerous countries. This study aimed to determine the incidence, clinical characteristics, and outcome of pertussis among infants in Sarawak, Malaysia.
We conducted a descriptive retrospective study of infants aged < 12 months with laboratory-confirmed pertussis admitted to Bintulu Hospital in Sarawak, Malaysian Borneo, from 2015 until 2021. Pertussis was confirmed in all patients using a polymerase chain reaction of nasopharyngeal aspirates.
Of 588 infants who had a nasopharyngeal aspirate, 108 (18%) had laboratory-confirmed pertussis. The average annual incidence was 482 per 100,000 infants aged < 12 months between 2015 and 2019, with a marked decline in 2020 and 2021. Eighty-two (76%) were < 3 months of age. Seventy-eight (72%) were unvaccinated for pertussis, including 75 (96%) who were too young to receive the first dose. A third of the cases had atypical presentations. Severe disease characterized by hypoxemia, pulmonary hypertension, recurrent apnea, encephalopathy, or cardiovascular dysfunction occurred in 32%. Forty-eight percent required humidified high-flow nasal cannula oxygen therapy and 22% required invasive ventilation. Twenty-four percent overall needed intensive care. One (1%) infant had a fatal outcome. Nearly all cases of severe disease or those that required invasive ventilation or intensive care had received ≤ 1 dose of pertussis vaccination.
A high incidence of pertussis with a high rate of severe disease was observed in Sarawak, Malaysia, predominantly among infants too young to be vaccinated. Additional vaccination strategies such as maternal vaccination or cocooning should be considered.
许多国家都报告了百日咳的死灰复燃。本研究旨在确定马来西亚砂拉越婴儿百日咳的发病率、临床特征和结局。
我们对 2015 年至 2021 年期间在砂拉越民都鲁 Bintulu 医院因实验室确诊的百日咳而住院的<12 个月婴儿进行了一项描述性回顾性研究。所有患者均通过聚合酶链反应检测鼻咽抽吸物来确诊百日咳。
在 588 名接受鼻咽抽吸物检查的婴儿中，有 108 名（18%）实验室确诊为百日咳。2015 年至 2019 年期间，<12 个月婴儿的年平均发病率为每 10 万婴儿 482 例，2020 年和 2021 年发病率显著下降。82 例（76%）<3 个月龄。78 例（72%）未接种百日咳疫苗，其中 75 例（96%）因年龄太小而无法接种第一剂疫苗。三分之一的病例表现不典型。32%的病例为严重疾病，表现为低氧血症、肺动脉高压、反复呼吸暂停、脑病或心血管功能障碍。48%需要湿化高流量鼻导管吸氧治疗，22%需要有创通气。24%的病例需要重症监护。1 例（1%）婴儿死亡。几乎所有严重疾病或需要有创通气或重症监护的病例均接受了≤1 剂百日咳疫苗接种。
在马来西亚砂拉越，观察到百日咳发病率高，且严重疾病发生率高，主要发生在年龄太小而无法接种疫苗的婴儿中。应考虑采取其他疫苗接种策略，如产妇接种或围产期保护。
