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        Alarm Thresholds for Pertussis Outbreaks in Iran: National Data Analysis

        Alimohamadi Yousef,Zahraei Seyed Mohsen,Karami Manoochehr,Yaseri Mehdi,Lotfizad Mojtaba,Holakouie-Naieni Kourosh 질병관리본부 2020 Osong Public Health and Research Persptectives Vol.11 No.5

        Objectives The purpose of the current study was to determine the upper threshold number of cases for which pertussis infection would reach an outbreak level nationally in Iran. Methods Data on suspected cases of pertussis from the 25th February 2012 to the 23rd March 2018 from the Center for Disease Control and Prevention in Iran was used. The national upper threshold level was estimated using the exponentially weighted moving average (EWMA) method and the Poisson regression method. Results In total, 2,577 (33.6%) and 1,714 (22.3%) cases were reported in the Spring and Summer respectively. There were 1,417 (18.5%) and 1,971 (25.6%) cases reported in the Autumn and Winter, respectively. The overall upper threshold using the EWMA and the Poisson regression methods, was estimated as a daily occurrence of 8 (7.55) and 7.50 (4.48–11.06) suspected cases per 10,000,000 people, respectively. The daily seasonal thresholds estimated by the EWMA and the Poisson regression methods were 10, 7, 6, 8 cases and 10, 7, 7, 9 cases for the Spring, Summer, Autumn, and Winter, respectively. Conclusion The overall and seasonal estimated thresholds by the 2 methods were similar. Therefore, the estimated thresholds of 6–10 cases in a day, per 10,000,000 people could be used to detect pertussis outbreaks and epidemics by health policymakers.

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        Comparing Seasonal Pattern of Laboratory Confirmed Cases of Pertussis with Clinically Suspected Cases

        Golam Reza Ghorbani,Seyed Mohsen Zahraei,Mahmood Moosazadeh,Mahdi Afshari,Fahimeh Doosti 질병관리본부 2016 Osong Public Health and Research Persptectives Vol.7 No.2

        Objectives: During recent decades, there has been limited attention on the seasonal pattern of pertussis within a high vaccine coverage population. This study aimed to compare the seasonal patterns of clinical suspected pertussis cases with those of laboratory confirmed cases in Iran. Methods: The current study was conducted using time series methods. Time variables included months and seasons during 2011-2013. The effects of seasons and months on the incidence of pertussis were estimated using analysis of variance or Kruskal-Wallis. Results: The maximum average incidence of clinically confirmed pertussis was 23.3 in July (p = 0.04), but the maximum incidence of clinical suspected pertussis was 115.7 in May (p = 0.6). The maximum seasonal incidences of confirmed and clinical pertussis cases were reported in summer (average: 12, p = 0.004), and winter (average: 108.1; p = 0.4), respectively. Conclusion: The present study showed that the seasonal pattern of laboratory confirmed pertussis cases is highly definite and different from the pattern of clinical suspected cases.

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