Introduction/Objective The Global Pertussis Initiative (GPI) proposed clinical case definitions for pertussis diagnosis in three different age cohorts in order to improve surveillance of pertussis especially in older children, adolescents, and adults. The main goal of this research was to compare the burden of pertussis in the city of Novi Sad before and after the introduction of improved surveillance using the GPI clinical case definitions of pertussis. Methods Baseline data on pertussis were obtained from routine (non-sentinel) reporting before improved surveillance was introduced. From September 16, 2012, clinical case definitions proposed by GPI were applied within improved (sentinel and hospital) surveillance, while surveillance clinical case definitions were not introduced within non-sentinel. To confirm the suspected diagnosis, sampling of nasopharyngeal swab and/or blood was obtained from all cases. The choice of laboratory method (PCR or ELISA) depended on the duration of coughing and the age of the patients. Data were statistically processed by SPSS Statistics, version 22. Results During the 12-year period before the introduction of improved surveillance, only two clinical pertussis cases were registered. In contrast, during the two-year period of improved surveillance, a total of 14 (season 2012/13) and 146 (season 2013/2014) confirmed pertussis cases were reported. Significant differences were determined in distribution of pertussis according to the type of surveillance and the level of health care. Conclusion Introduction of clinical case definitions proposed by GPI improved the quality of surveillance and enabled an insight in the distribution of pertussis in all age groups and at all levels of health care.

Serotype distribution of Streptococcus pneumoniae in the population fairly overlaps with the serotypes contained in pneumococcal vaccines, so that implementation of childhood immunization is justified. The study was done in the Province of Vojvodina but the findings may be applied to Serbia as a whole.

No abstract

No abstract

BackgroundIn an effort to improve the pertussis diagnosis, the Global Pertussis Initiative (GPI) proposed an algorithm of the signs/symptoms of pertussis for three age groups: 0–3 months, 4 months to 9 years, and ≥10 years of age.MethodsWe evaluated the accuracy of the clinical case definitions for pertussis proposed by the GPI using laboratory-confirmed pertussis as a reference standard for four groups: clinically suspected pertussis without comorbidity; asthma exacerbation; allergic constitution, and other diagnoses (bronchitis, bronchiolitis, laryngitis, and tracheitis). We included only patients who fulfilled one or more criteria of clinical case definitions for the age groups (0–3 months, 4 months–9 years, and ≥10 years of age).The data for this prospective epidemiological study were collected between 1st January 2013–31st December 2016 at the outpatients and inpatients health care settings in the South Bačka District of Autonomous Province of Vojvodina, Serbia. We evaluated accuracy of the certain sign and symptom combinations of GPI case definitions based on their sensitivity, specificity, and likelihood ratios.ResultsA total of 1043 participants were included, with 306 (29.3%) laboratory-confirmed pertussis cases. In patients aged 0–3 months, whoop and apnoea associated with laboratory confirmation of pertussis. In patients aged 4 months-9 years with a pertussis suspicion infection or with one of the other diagnoses, the highest accuracy was found for whoop combined with apnoea or post-tussive emesis. In patients aged 10 years and older, several different sign and symptom combinations were associated with an increased risk of pertussis among all enrolment diagnoses. There were fewer hospitalizations among the fully vaccinated children than in partly or unvaccinated children aged 4 months to 6 years (20.7% vs. 60.0%, p = 0.017).ConclusionsThe numerous sign and symptom combinations in the observed case definitions were good predictors for laboratory-confirmed pertussis among all enrolment diagnoses, therefore suggesting the necessity for increased awareness of possibility for pertussis in patients with certain pertussis-like medical conditions.