Risk factors for hospitalization in children with pertussis in Pattani Province

Abstract

Background: Pertussis affects people in all age groups and it is particularly severe in young children. The pertussis vaccination rate in Pattani Province had been 73%, below the national average of 88%, and continued to decline since 2022. Pertussis incidence has been on the rise since August 2023. Identifying risk factors for hospitalization in pertussis may help in improving prevention and care.

Objective: To study risk factors for hospitalization in children with pertussis.

Methods: This exploratory prognostic factor research used a retrospective design. Pediatric patients (age <15 years) diagnosed with pertussis in Pattani Province were enrolled from August 2023 to July 2024. Clinical data from hospital charts were collected and reviewed. Patients were divided into children with mild symptoms and those requiring hospitalization. Demographics, pertussis vaccination history, symptoms and pneumonia (n, %, and mean ± SD) were compared using the exact probability test and t-test. Multivariable logistic regression was used to find the risk factors, and presented with multivariable odds ratios (mOR).

Results: Of the 333 children with confirmed pertussis, 56.7% were male, with the mean age of 3.3 years old. Pneumonia was present in 17.7%, and 42% of them required hospitalization. statistically significant higher prevalence in children reguiring hospitalization included young age, fever, apneic spells, paroxysmal cough, posttusive vomiting, pneumonia, leukocytosis (white blood cell, WBC >25,000 cells/cu.mm.), lymphocytosis (lymphocyte >60%) and thrombocytosis (platelet count >450,000/cu.mm.). Multivariable analysis identified risk factors for hospitalization in children with pertussis included fever, paroxysmal cough, pneumonia, lymphocytosis and thrombocytosis.

Conclusions: Children who had fever, pneumonia, lymphocytosis and thrombocytosis were at higher risk for severe symptoms requiring hospitalization.