Factors Associated With Time to Appropriate Treatment in Pertussis Cases: Georgia 2009-2013 Open Access

Goodenough, Dana Nicole (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/td96k2720?locale=en


Introduction: Pertussis is endemic in the United States, with periodic epidemics that continue to highlight its importance as a public health issue. Pertussis infection can cause a variety of symptoms, and the clinical presentation of pertussis can vary by age and vaccine status. However, little is known about the factors that affect time to treatment of pertussis cases. We analyzed five years of data from the Georgia Emerging Infections Program to understand how factors such as age, symptoms, and vaccine status can alter the clinical picture of pertussis and impact time to appropriate treatment.

Methods: We used multivariable linear regression to assess the impact of each variable on time to treatment.

Results: There was little consistency across age groups for symptom and demographic predictors of time to treatment. Overall, the multivariate liner regression showed that among patients aged 18 and younger, none of the variables had an impact on time to treatment greater than -0.25 to +1.47 days. Among patients over 18 years and older, most variables had little impact on time to treatment, though two (paroxysmal cough in 18-40 year olds and hospitalization in individuals over 40 years of age) were associated with at least a five day increase in time to treatment;

Conclusions: This study highlights how the difficulties in pertussis diagnosis can impact time to treatment, particularly for individuals aged 18 and older who may not begin treatment until there is an accumulation of symptoms. Healthcare providers need to recognize the variety of symptoms that pertussis can present with and consider confirmatory testing early.

Table of Contents

Chapter I: Background/Literature Review 1

Chapter II: Manuscript 8

A. Title, Author(s), Abstract 8

B. Background 10

C. Methods 11

D. Results 13

E. Discussion 15

F. References 21

G. Tables 24

10. Chapter III: Summary, Public Health Implications, Possible Future Directions 29

11. Appendices 30

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