Study Clinical and Epidemiological of Whooping Cough in Breast-Fed Babies under 6 months admitid in three Hospitals of Lima - Perú over the years 2003 – 2008

Abstract

Objective: To evaluate the clinical and epidemiological characteristics of breastfeeding under 6 months admitted by whooping cough in 3 hospitals of Lima: Instituto Nacional de Salud del Niño (INSN), Hospital de Emergencias Pediátricas (HEP) and Hospital Nacional Daniel Alcides Carrión (HNDAC) between the years 2003-2008.

Material and methods: There was realized a descriptive study. There was gather the information of the clinical histories of breastfed babies under of 6 months by the diagnosis of Syndrome Coqueluchoide and/or Whooping Cough in a card. The final diagnosis of Whooping Cough was realized on the basis of the operative definitions of the MINSA.

Results: 589 clinical histories were located, of them 312/589 (53 %) they were a whooping cough; 293/312 (94 %) there were probable cases, 19/312(6%) cases confirmed, of them 15 for IFD and 4 for culture. It was observed more number of hospitalization in spring and summer. The parents (48.2 %) and of them the mother (36.5 %), was the frequent epidemiological contacts. Of 70 breast-fed babies over 3 months, the 30% not had the doses adequate of vaccine DTPw to the moment to fall ill, therefore were not protected. The breast-fed babies minor or equal of 3 months (242/312) presented with more frequency severe signs: apnea (90 %), impede to feed (83,9 %) and cyanosis (78,4 %). The most frequent complications were: bronchial obstruction (63.3 %), pneumonia (25 %) and atelectasia (6 %). There died eight breast-fed babies (2,6 %). The reasons of death were: pneumonia and sepsis 4/8, sepsis 3/8 and a case for Acute respiratory Distress syndrome.

Conclusions: The majority of the breast-fed babies under of 6 months, were defined as probable cases of Whooping Cough. We found a prevalence of cases confirmed of 6 %. They were hospitalized more in the springs months and summer. The most frequent epidemiological contact were the parents and of them the mother. The majority of the breast-fed babies under of 6 months were had no full complete dose of vaccine DTPw. The lethality was 2.6 %.