title: Attitude of Italian physicians toward pertussis diagnosis.
abstract: Resurgence of pertussis has been observed in several countries whereas Italy continues to be a low incidence country. We hypothesize that the low reported incidence of pertussis in Italy could be biased by the attitude of physicians to suspect and diagnose pertussis in different age groups. We investigated the attitude of Italian physicians toward pertussis diagnosis through clinical scenarios. A cross-sectional study was conducted in June 2012 sending online questionnaires to pediatricians and general practitioners (GPs) involved in ambulatory primary care. The questionnaire included five clinical scenarios of patients of different ages (45 d, 5 y, 11 y, 24 y, 58 y) with prolonged cough of at least 2 weeks. Respondents were asked to choose a diagnosis among a list of 14. We observed a decreasing trend of suspected pertussis diagnosis with increasing age of the patient (from 46% at 45 d to 0 at 58 y). In Italy pertussis is seldom suspected in the differential diagnosis of cough particularly in adults. This may cause a significant under-notification of pertussis, with a higher impact in older age groups. Educational programs should be reinforced to consider the differential diagnosis of pertussis in individuals with atypical presentation and in older age groups.
authors.affiliation: Bambino Gesù Children's Hospital; IRCCS; Rome, Italy.
authors.forename: Michaela Veronika
authors.initials: MV
authors.lastname: Gonfiantini
authors.forename: Alberto
authors.initials: A
authors.lastname: Villani
authors.forename: Francesco
authors.initials: F
authors.lastname: Gesualdo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pandolfi
authors.forename: Eleonora
authors.initials: E
authors.lastname: Agricola
authors.forename: Elena
authors.initials: E
authors.lastname: Bozzola
authors.forename: Raffaele
authors.initials: R
authors.lastname: Arigliani
authors.forename: Alberto Eugenio
authors.initials: AE
authors.lastname: Tozzi
mesh_terms: D001291:Attitude of Health Personnel; D003371:Cough / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014917:Whooping Cough / Q000175:diagnosis* / Q000453:epidemiology
keywords: chronic cough; general practitioners; pediatricians; pertussis; under-notification