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Sensitivity and specificity of the World Health Organization pertussis clinical case definition

Roxana Mansour Ghanaie1, Abdollah Karimi, Hossein Sadeghi

  • 1Pediatric Infectious Diseases Research Center, Mofid Children's Hospital, Shariati Street, Tehran, Iran.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|October 19, 2010
PubMed

Insights

Pertussis, caused by Bordetella pertussis, is a significant cause of prolonged cough in vaccinated children. The World Health Organization (WHO) clinical criteria show low specificity for diagnosing pertussis compared to PCR.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Bordetella pertussis continues to circulate globally, even in highly vaccinated populations.
  • Prolonged cough in children can be attributed to various etiologies, including pertussis.

Purpose of the Study:

  • To determine the relationship between documented Bordetella pertussis infection and the clinical criteria proposed by the World Health Organization (WHO).

Main Methods:

  • Nasopharyngeal swabs were collected from 6-14-year-old school children in Tehran with cough lasting at least two weeks.
  • Samples were tested for Bordetella pertussis and Bordetella parapertussis using culture and polymerase chain reaction (PCR).

Main Results:

  • Out of 6601 students, 328 (5.0%) had a cough of at least two weeks. PCR detected B. pertussis in 6.4% and B. parapertussis in 1.8%.
  • Culture confirmed B. pertussis in 1.2% of samples.
  • The World Health Organization (WHO) clinical criteria demonstrated a sensitivity of 95.2% and a specificity of 15.0% compared to PCR.

Conclusions:

  • Pertussis remains a key cause of prolonged cough in children, even in areas with high immunization rates.
  • The specificity of the WHO clinical criteria for diagnosing pertussis is low when compared to PCR.
Abstract

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