Failure of physicians to consider the diagnosis of pertussis in children.
To determine the ability of physicians to make a diagnosis of pertussis and factors associated with improved diagnosis, 8,235 children from 88 child care centers and 14 elementary schools from Quebec City, Quebec, Canada, were evaluated by using a questionnaire completed by parents and a medical record review. Children must have consulted a physician to be included in the evaluation. There were 558 children meeting the surveillance case definition and 416 meeting a modified World Health Organization case definition who consulted a physician. A diagnosis of pertussis was considered in 24%-26% of children meeting either case definition, made in 12%-14%, and reported for 6%. Pertussis diagnosis was significantly associated with having a history of pertussis exposure (P < or = .003), four pertussis-related symptoms (P < .001), and a cough for > or = 5 weeks (P < or = .05) and consulting in a hospital setting (P < or = .03). The proportion of cases of pertussis diagnosed and reported is low even when children present with classical symptoms.
Deeks
S
S
Laboratory Centre for Disease Control, Ottawa, Ontario, Canada.
De Serres
G
G
Boulianne
N
N
Duval
B
B
Rochette
L
L
Déry
P
P
Halperin
S
S
D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005194:Family Practice; D006801:Humans; D010818:Practice Patterns, Physicians'; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D011795:Surveys and Questionnaires; D014917:Whooping Cough / Q000175:diagnosis* / Q000453:epidemiology