【摘要】 目的 分析江苏省儿童百日咳突破病例流行病学特征。方法 收集2024年江苏省4月龄～5岁儿童百日咳突破病例和含无细胞百日咳成分疫苗(Acellular pertussis-containing vaccine,aP)接种信息，分析百日咳突破病例发病密度、接种至发病时间间隔和住院率。结果 2024年江苏省报告百日咳突破病例3 952例，发病密度为0.63/万人月;Poisson回归分析显示，苏南、苏中地区发病密度高于苏北地区[发病率比(Incidence rate ratio,IRR)(95%CI):3.41(3.12～3.72)、1.78(1.58～2.01)]，接种2剂次、3剂次、4剂次aP发病密度低于接种1剂次[IRR(95%CI):0.29(0.23～0.37)、0.07(0.06～0.08)、0.02(0.01～0.03)]。突破病例发病时间间隔中位数为2.3年，其中接种1剂次、2剂次、3剂次、4剂次aP分别为0.1年、0.1年、0.8年、2.9年(H=1 835.67,P<0.001)。突破病例住院率为23.71%(937例)，多因素Logistic回归分析显示，4～11月龄、1岁、3岁组住院率高于5岁组[OR(95%CI):3.49(2.24～5.46)、3.07(2.24～4.23)、4.24(3.23～5.60)]，苏南、苏中地区住院率低于苏北地区[OR(95%CI):0.48(0.36～0.65)、0.48(0.39～0.59)]，住院率随aP接种剂次增加而降低[OR(95%CI):0.70(0.59～0.82)]。结论 2024年江苏省4月龄～5岁儿童百日咳突破病例发病和住院风险存在年龄和地区差异;随着a P接种剂次增加，发病和住院风险下降，发病时间间隔延长。需加强适龄儿童a P及时和全程接种，以及百日咳早发现和规范治疗。更多还原

【Abstract】 Objective To analyze epidemiological characteristics of breakthrough pertussis among children of Jiangsu province. Methods We obtained data on breakthrough pertussis cases and administration of acellular pertussis-containing vaccine( aP) among children aged 4 months to 5 years in Jiangsu in 2024 and analyzed incidence density,illness onset time since vaccination,and hospitalization rate. Results A total of 3 952 breakthrough pertussis cases were reported among children 4 months to 5 years of age in Jiangsu in 2024,yielding an incidence density of 0. 63 per 10 000 person-months. Poisson regression analysis showed that the incidence density was higher in southern and central areas than in northern areas[Incidence rate ratio( IRR)( 95% CI) : 3. 41( 3. 12-3. 72) and 1. 78( 1. 58-2. 01) ],and was lower among children who had received 2,3,or 4 doses of a P than among children who had received 1 dose of a P[IRR( 95% CI) : 0. 29( 0. 23-0. 37),0. 07( 0. 06-0. 08),and 0. 02( 0. 01-0. 03) ]. The median illness onset time since vaccination was 2. 3 years,and was 0. 1,0. 1,0. 8,and 2. 9 years in cases who had received 1,2,3,or 4 doses of aP,respectively( H = 1 835. 67,P < 0. 001). The overall hospitalization rate was 23. 71%( 937 cases). Multivariable logistic regression analysis showed that the hospitalization rate was higher in 4-11-month-olds,1-year-olds,and 3-year-olds than in 5-year-olds[OR( 95% CI) : 3. 49( 2. 24-5. 46),3. 07( 2. 24-4. 23),and 4. 24( 3. 23-5. 60) ],was lower in southern and central areas than in northern areas[OR( 95% CI) : 0. 48( 0. 36-0. 65) and 0. 48( 0. 39-0. 59) ],and decreased with increasing aP doses administered [OR( 95% CI) : 0. 70( 0. 59-0. 82) ].Conclusions The incidence and risk of hospitalization of breakthrough pertussis cases among children4 months to 5 years of age in Jiangsu in 2024 varied by age and area and decreased with increasing aP doses administered. The interval between vaccination and illness onset increased with increasing numbers of aP doses administered. We should strengthen timely and full-series vaccination with aP for age-eligible children and early detection with standardized treatment of pertussis.更多还原