Whooping cough in Sudanese children

The study describes the epidemiological and clinical features of whooping cough among eighty one Sudanese children (42 cases and 39 contacts aged below fifteen years) within 37 households who were under surveillance for a period of over six months. Using Khartoum Children's Emergency Hospital as the entry point, eleven patients were initially enrolled between July 1989 and August 1990 and led to the identification of another twenty six cases during home surveys. Subsequently, five of their contacts became secondary cases. The clinical criteria adopted by the Expanded Programme on Immunisation of the World Health Organization were used to identify the total of forty two cases included in the study. They were predominantly females (male: female ratio of 1:1.6), twenty (47.6%) were under five years of age and eight (19%) were infants. The attack rate was significantly higher among unimmunised infants (100%) compared to unimmunised children aged ten years and above (14.3%, p = 0.001). Half of the patients were from periurban areas, the majority (83.3%), were living in crowded households (room index > 5) and the primary immunisation rate was low (2.8%). Abnormal chest x-ray findings were detected in 26 (68.4%) patients and consisted mainly of bronchovascular thickening observed in 50%. During the follow-up period, a trend towards drop in patients' weight was observed. In four weeks, thirty (71.4%) children had a mean loss of 0.4 kg whereas eleven (26.2%) had static weight. A group of fifteen cases showed significant decrease in weight when compared to a control group of contacts that had been matched for age, sex and socio-economic status (p = 0.0001).