Pertussis in Latin America and the Hispanic Caribbean: a systematic review

<b>Introduction:</b> Pertussis in Latin America continues to cause periodic epidemics with substantial morbidity particularly among young children. The disease has persisted despite long-standing vaccination programs in the region. <b>Areas covered:</b> We conducted a systematic review to characterize the recent epidemiology of pertussis in Latin America and Hispanic Caribbean. We undertook a holistic approach and attempted to include all available data concerning pertussis that may explain the changing dynamics of the disease. <b>Expert opinion:</b> There are wide disparities in the reported annual incidence rates of pertussis both within and between countries in the region. General trends in pertussis incidence are difficult to ascertain due to the heterogeneity in the epidemiological data. Available data suggests that the disease burden has changed over the years such that now it predominantly affects those &lt;1 year. Coverage with three doses of the pertussis vaccine has been highly variable, and very few countries have consistently achieved ≥90% coverage annually since 2000. There remain inequalities in vaccination coverage in some regions/localities and specific groups, which sustains the risk of pertussis dissemination. The WHO considers that maternal pertussis immunization provides protection to infants too young to be vaccinated; &gt;10 Latin American countries currently recommend vaccination of pregnant women.

**引言：** 百日咳（pertussis）在拉丁美洲仍持续引发周期性流行，造成沉重的疾病负担，尤其对幼儿群体影响显著。尽管该地区已推行长期疫苗接种计划，这一疾病仍持续存在。
**综述范围：** 本研究开展了一项系统综述，旨在阐明拉丁美洲及西班牙裔加勒比地区百日咳的近期流行病学特征。本研究采用全面研究思路，力求纳入所有可获取的、可阐释该疾病流行动态变化的百日咳相关数据。
**专家观点：** 该区域各国国内及国与国之间，百日咳报告年发病率存在显著差异。由于流行病学数据存在异质性，难以明确百日咳发病率的总体变化趋势。现有数据显示，疾病负担已随时间发生转变，如今百日咳主要感染年龄小于1岁的婴幼儿。百日咳疫苗3剂次接种覆盖率差异悬殊，自2000年以来，仅有极少数国家能够持续实现每年接种覆盖率≥90%的目标。部分区域、地区及特定群体的疫苗接种覆盖率仍存在不平等现象，这持续维持了百日咳传播的风险。世界卫生组织（WHO）认为，孕产妇百日咳疫苗接种可为年龄过小无法接种疫苗的婴儿提供保护；目前已有超过10个拉丁美洲国家推荐为孕妇接种百日咳疫苗。