Pertussis in Latin America and the Hispanic Caribbean: a systematic review

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Pertussis (whooping cough) persists in Latin America, causing periodic epidemics and significant illness, particularly in young children.
• Established vaccination programs have not fully controlled the disease's endemic circulation in the region.

Purpose of the Study:

• To systematically review and characterize the recent epidemiology of pertussis in Latin America and the Hispanic Caribbean.
• To explore factors contributing to the changing dynamics of pertussis transmission and incidence.

Main Methods:

• A systematic review approach was employed to gather and analyze available data on pertussis.
• A holistic strategy was used to include diverse data sources explaining disease dynamics.

Main Results:

• Significant disparities exist in reported pertussis incidence rates across and within countries.
• Pertussis epidemiology is heterogeneous, making trend analysis challenging; the disease burden increasingly affects infants under one year old.
• Vaccine coverage for pertussis is highly variable, with few countries consistently achieving the recommended 90% target since 2000. Inequalities in coverage persist, fueling disease spread.

Conclusions:

• Inconsistent pertussis vaccination coverage and regional inequalities contribute to ongoing disease transmission.
• Maternal pertussis immunization is recognized by the WHO as a strategy to protect unvaccinated infants.
• Over ten Latin American countries now recommend vaccinating pregnant women against pertussis.