Related Experiment Video
Updated: Jun 9, 2025
Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
Incidence and severity of pertussis among hospitalized infants, Sarawak, Malaysia, 2015-2021
Anand Mohan1, Yee-Yen Tan1, Rohaidah Hashim2
1Department of Pediatrics, Bintulu Hospital, Ministry of Health Malaysia, Bintulu, Sarawak, Malaysia.
Insights
Pertussis (whooping cough) is highly prevalent in infants in Sarawak, Malaysia, causing severe illness and requiring intensive care. Vaccination, especially for mothers and close contacts, is crucial to protect vulnerable infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pertussis (whooping cough) is experiencing a global resurgence.
- Infant pertussis poses significant health risks, particularly in regions with lower vaccination coverage.
Purpose of the Study:
- To investigate the incidence, clinical features, and outcomes of pertussis in infants in Sarawak, Malaysia.
- To inform public health strategies for pertussis prevention in vulnerable infant populations.
Main Methods:
- A descriptive retrospective study was conducted on infants under 12 months old.
- Laboratory confirmation of pertussis was performed using polymerase chain reaction (PCR) on nasopharyngeal aspirates.
- Data were collected from Bintulu Hospital, Sarawak, between 2015 and 2021.
Main Results:
- The annual incidence of pertussis was high, averaging 482 per 100,000 infants (2015-2019).
- Most cases (76%) occurred in infants under 3 months old, with 72% unvaccinated.
- Severe disease (32%) required intensive care, including ventilation, with one fatality (1%).
Conclusions:
- Sarawak, Malaysia, faces a high incidence of pertussis among unvaccinated infants, leading to severe outcomes.
- Maternal vaccination and cocooning strategies are recommended to protect infants too young for primary immunization.
Introduction:
A resurgence of pertussis has been reported in numerous countries. This study aimed to determine the incidence, clinical characteristics, and outcome of pertussis among infants in Sarawak, Malaysia.
Methodology:
We conducted a descriptive retrospective study of infants aged < 12 months with laboratory-confirmed pertussis admitted to Bintulu Hospital in Sarawak, Malaysian Borneo, from 2015 until 2021. Pertussis was confirmed in all patients using a polymerase chain reaction of nasopharyngeal aspirates.
Results:
Of 588 infants who had a nasopharyngeal aspirate, 108 (18%) had laboratory-confirmed pertussis. The average annual incidence was 482 per 100,000 infants aged < 12 months between 2015 and 2019, with a marked decline in 2020 and 2021. Eighty-two (76%) were < 3 months of age. Seventy-eight (72%) were unvaccinated for pertussis, including 75 (96%) who were too young to receive the first dose. A third of the cases had atypical presentations. Severe disease characterized by hypoxemia, pulmonary hypertension, recurrent apnea, encephalopathy, or cardiovascular dysfunction occurred in 32%. Forty-eight percent required humidified high-flow nasal cannula oxygen therapy and 22% required invasive ventilation. Twenty-four percent overall needed intensive care. One (1%) infant had a fatal outcome. Nearly all cases of severe disease or those that required invasive ventilation or intensive care had received ≤ 1 dose of pertussis vaccination.
Conclusions:
A high incidence of pertussis with a high rate of severe disease was observed in Sarawak, Malaysia, predominantly among infants too young to be vaccinated. Additional vaccination strategies such as maternal vaccination or cocooning should be considered.
Related Concept Videos
01:51Vaccinations
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:18Steps in Outbreak Investigation
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Pneumonia III: Complications and Assessment