When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)

Introduction: Despite the reported cases of whooping cough in Armenia, there has been no formal evaluation of “who these cases are and their load on hospital wards”. In a tertiary reference hospital, we determined the trend in hospitalized pertussis cases stratified by vaccination status and risk f...

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Main Authors: Sose Margaryan, Markus Wells, Hripsime Apresyan, Tatevik Grigoryan, Kristina Akopyan, Olga Denisiuk, Rony Zachariah, Karapet Davtyan
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2019-05-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/11121
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author Sose Margaryan
Markus Wells
Hripsime Apresyan
Tatevik Grigoryan
Kristina Akopyan
Olga Denisiuk
Rony Zachariah
Karapet Davtyan
author_facet Sose Margaryan
Markus Wells
Hripsime Apresyan
Tatevik Grigoryan
Kristina Akopyan
Olga Denisiuk
Rony Zachariah
Karapet Davtyan
author_sort Sose Margaryan
collection DOAJ
description Introduction: Despite the reported cases of whooping cough in Armenia, there has been no formal evaluation of “who these cases are and their load on hospital wards”. In a tertiary reference hospital, we determined the trend in hospitalized pertussis cases stratified by vaccination status and risk factors associated with apnea and hospital stay. Methodology: Retrospective cohort study of children (< 18 years) with confirmed pertussis hospitalized at the Republican Infectious Diseases Hospital between 2014 and 2018. Multivariate logistic regression was used to identify risk factors. Results: The majority (62%) of 116 children (44% female, mean age 21 months) were from regions outside the capital city of Yerevan. Standardized pertussis admissions increased by almost fivefold, from 2.2/1,000 in 2014 to 10.6/1,000 in 2018. The cumulative average percentage (2014-2018) of children not vaccinated against pertussis was 33%, while 29% were completely vaccinated. Twenty-five children (21%) had apnea, two of whom died. Younger age (Odds Ratio (OR) = 1.04; P = 0.05), not having been vaccinated (OR = 3.57; P = 0.01) and having comorbidities (OR = 4.1; P = 0.09) were associated with apnea. After adjusting for age, the longer hospital stay (>8 days) was significantly associated with non-vaccination (OR = 5.0, P = 0.002). Conclusions: There is a progressive increase in rate of hospital admissions for pertussis meriting closer vigilance on a national scale. Unvaccinated children of younger age are predisposed to apnea and longer hospitalization and would benefit from early referral to specialized infectious units. This may improve clinical outcomes and reduce hospital burden.
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institution Kabale University
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spelling doaj-art-e8a98377554e454eaa186e8edf54301c2025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802019-05-011305.110.3855/jidc.11121When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)Sose Margaryan0Markus Wells1Hripsime Apresyan2Tatevik Grigoryan3Kristina Akopyan4Olga Denisiuk5Rony Zachariah6Karapet Davtyan7FMD K and L Europe, Yerevan, ArmeniaFMD K and L Europe, Yerevan, ArmeniaHeratsi Yerevan State Medical University, Yerevan, ArmeniaFMD K and L Europe, Yerevan, ArmeniaGerald and Patricia Turpanjian School of Public Health, American University of Armenia, Yerevan, ArmeniaAlliance for Public Health, Kiev, UkraineUNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, SwitzerlandFMD K and L Europe, Yerevan, Armenia Introduction: Despite the reported cases of whooping cough in Armenia, there has been no formal evaluation of “who these cases are and their load on hospital wards”. In a tertiary reference hospital, we determined the trend in hospitalized pertussis cases stratified by vaccination status and risk factors associated with apnea and hospital stay. Methodology: Retrospective cohort study of children (< 18 years) with confirmed pertussis hospitalized at the Republican Infectious Diseases Hospital between 2014 and 2018. Multivariate logistic regression was used to identify risk factors. Results: The majority (62%) of 116 children (44% female, mean age 21 months) were from regions outside the capital city of Yerevan. Standardized pertussis admissions increased by almost fivefold, from 2.2/1,000 in 2014 to 10.6/1,000 in 2018. The cumulative average percentage (2014-2018) of children not vaccinated against pertussis was 33%, while 29% were completely vaccinated. Twenty-five children (21%) had apnea, two of whom died. Younger age (Odds Ratio (OR) = 1.04; P = 0.05), not having been vaccinated (OR = 3.57; P = 0.01) and having comorbidities (OR = 4.1; P = 0.09) were associated with apnea. After adjusting for age, the longer hospital stay (>8 days) was significantly associated with non-vaccination (OR = 5.0, P = 0.002). Conclusions: There is a progressive increase in rate of hospital admissions for pertussis meriting closer vigilance on a national scale. Unvaccinated children of younger age are predisposed to apnea and longer hospitalization and would benefit from early referral to specialized infectious units. This may improve clinical outcomes and reduce hospital burden. https://jidc.org/index.php/journal/article/view/11121whooping coughpertussisvaccinationinfant mortalityhospital burdenSORT IT
spellingShingle Sose Margaryan
Markus Wells
Hripsime Apresyan
Tatevik Grigoryan
Kristina Akopyan
Olga Denisiuk
Rony Zachariah
Karapet Davtyan
When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
Journal of Infection in Developing Countries
whooping cough
pertussis
vaccination
infant mortality
hospital burden
SORT IT
title When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
title_full When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
title_fullStr When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
title_full_unstemmed When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
title_short When will the coughing stop? Characteristics of children with pertussis (whooping cough) in Armenia (2014-2018)
title_sort when will the coughing stop characteristics of children with pertussis whooping cough in armenia 2014 2018
topic whooping cough
pertussis
vaccination
infant mortality
hospital burden
SORT IT
url https://jidc.org/index.php/journal/article/view/11121
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