Peer-reviewed article
Influencing factors for severe pertussis among Chinese children: A meta-analysis.
Yingying Yang, Yaning Zhuo, Xinren Che, Wenwen Gu, Zhaojun Lu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This meta-analysis of 24 Chinese studies examined factors associated with severe pertussis in children, analysing 839 severe cases and 4,280 non-severe cases. The strongest risk factors for severe pertussis were lung complications, imaging signs of disease progression, elevated inflammatory markers, lack of DTP vaccination, and high white blood cell counts. The authors highlight that vaccination and early detection of clinical warning signs can reduce severe cases.
Key points
- Lung consolidation or atelectasis showed the strongest association with severe pertussis (OR: 15.44)
- Lack of DTP vaccination was the fifth strongest risk factor (OR: 4.00), demonstrating the protective effect of vaccination
- Elevated C-reactive protein and white blood cell counts were significantly associated with severe disease
- The meta-analysis identified key clinical and laboratory markers that can enable early identification of children at risk of severe pertussis
- Strengthening vaccination coverage and early intervention based on identified risk factors are recommended to reduce severe cases
Limitations
The meta-analysis is limited to studies from China and may not be generalizable to other populations. The document does not discuss the quality assessment of included studies, potential publication bias, or heterogeneity between studies.
Abstract
This study systematically evaluates factors influencing severe pertussis in Chinese children, providing scientific evidence for its prevention and treatment. A comprehensive search of PubMed, Embase, Web of Science, CNKI, and Wanfang identified literature on factors influencing severe pertussis in Chinese children up to September 30, 2025. We conducted a meta-analysis, and data were combined using either fixed or random models. A total of 24 studies included 839 severe pertussis cases and 4,280 non-severe cases. Severe pertussis was significantly associated with several factors, with the top five strongest associations being: lung consolidation or atelectasis (OR: 15.44; 95%CI: 9.06-26.31), three concave sign (OR: 12.91; 95%CI: 5.46-30.53), elevated C-reactive protein (OR: 5.33; 95%CI: 3.00-9.49), unvaccinated with DTP vaccine (OR: 4.00; 95%CI: 2.86-5.58), and white blood cell count (WMD: 16.42 × 109/L; 95%CI: 9.49-23.36). Early identification of these factors and timely intervention, along with strengthening vaccination efforts for children, can help effectively reduce severe cases.