Sultan Qaboos University Hospital
Pediatric Critical Care medicine, Child Health Department

Author Of 1 Presentation

CRITICAL PERTUSSIS: RISK FACTORS AND OUTCOMES IN A MIDDLE EASTERN SETTINGS

Presenter
Room
Papageno Hall
Date
19.06.2019
Session Time
13:40 - 15:10
Duration
7 Minutes

Abstract

Background

Despite widespread vaccination, pertussis continues to occur with significant incidence worldwide and causes morbidity and mortality(1). Few studies have reported risk factors associated with critical pertussis including age <6months, incomplete DTaP vaccination and hyperleukocytosis(2,3). In the middle east,little has been published about critical pertussis.

Objectives

To describe demographics, outcomes and associated risk factors for critical pertussis in Oman.

Methods

In this retrospective study, we reviewed the Electronic Medical Records of all patients aged <13years who presented to the university-affiliated tertiary center in Oman with a positive PCR test for pertussis between January 2013 and June 2018. Data including demographics, possible risk factors of severity, and patient outcomes were recorded.

Results

A total of 69 children were enrolled, 34(49%) were aged <2months, 65(94%) aged <4months, 62(90%) received no or 1 DTaP vaccine and 40(58%) were male. 38(55%) patients had lymphocytosis and 7(10%) had WBC>50 000/mm3.

Of the total, 9(13%) were discharged from ER, 18(26%) required pediatric high dependency(PHDU) and 6(8.7%) required PICU care. Pulmonary complications were commonest 23(33). 9(13%) required assisted ventilation. Others included secondary bacterial infections 11(16%), seizures 3(4%), pulmonary hypertension 1(1%), and death 1(1%).

Factors associated with PICU/PHDU admission (p<0.05) were leukocytosis >50x109/L, elevated C-Reactive Protein, development of secondary bacterial infection, infiltrates seen on chest-radiograph and seizures at presentation.

Conclusion

Similar to other countries worldwide, pertussis remains a significant cause of morbidity and mortality in Oman. The youngest age groups with incomplete vaccination especially with leukocytosis and elevated CRP are at highest risk. Therefore, protection of infants by vaccinating pregnant mothers is recommended.

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