Global, regional, and national epidemiology of pertussis in children from 1990 to 2021

Background: This study examines the trends in pertussis incidence, mortality, and disability-adjusted life-years (DALYs) among children from 1990 to 2021. Methods: Data on pertussis incidence, mortality, and DALYs rates in children were extracted from the Global Burden of Disease (GBD) database, covering 1990-2021 across 204 countries and regions. Children were divided into four age groups: under 1 year, 1-4 years, 5-9 years, and 10-14 years. Data were categorized by age, gender, year, region, and Socio-demographic Index (SDI). The estimated annual percentage change (EAPC) method to assess trends. Results: In 2021, a downward trend was observed in global childhood pertussis incidence, mortality, and DALYs. Over 30 years, global pertussis cases fell by 77.73 % (EAPC -2.62, 95 % Confidence interval [CI] -3.35 to -1.89), deaths by 80.3 % (EAPC -3.24, 95 % CI -3.97 to -2.51), and DALYs by 80.29 % (EAPC -3.24, 95 % CI -3.97 to -2.50). Before the 2020 COVID-19 outbreak, only low SDI regions showed increasing pertussis cases in children. Children under one year had the highest incidence, mortality, and DALYs. Female children generally had higher rates than males. Post-2020, global incidence and mortality rates significantly declined, likely due to COVID-19-related measures. Conclusion: Globally, childhood pertussis incidence, mortality, and DALYs have decreased over 30 years. However, in low SDI regions like Somalia, the pertussis burden remains high, necessitating financial and medical support. Given the high rates among children under one year, vaccination efforts, timely diagnosis, and prevention of complications are crucial.