Pertussis: Knowledge, Attitudes, and Practices (KAP) Among Georgia Pediatricians

Background: In 2010, 27,550 pertussis cases were reported nationally – the highest since 1959. GA reported one third the national rate, though the true rate is likely higher.  To enhance surveillance, the GA Department of Public Health and the GA Chapter of the AAP surveyed pediatricians to assess their KAP about pertussis.

Objectives: To improve pertussis control in GA by identifying aspects of pertussis diagnosis and management perceived as barriers by GA practitioners.

Methods: An online survey assessing physicians’ KAP regarding pertussis, perceived barriers to diagnosis, and practice characteristics was administered to all 1100 members of the GA AAP. Frequencies and statistical analyses were conducted using SAS.

Results: Of the 115 respondents (10% response rate), 71% believed clinical judgment alone was not sufficient for diagnosis. Only 66% were aware that immunity after infection is not life-long.  50% were aware that serology is not a reliable diagnostic method, while only 7% were aware that polymerase chain reaction (PCR) testing is not reliable nor is it commercially standardized (26%). Although pertussis is an immediately notifiable disease, only 32% ever reported a suspect case to Public Health within 24 hours; 49% waited until laboratory results were obtained. 85% of respondents reported testing for pertussis, with PCR the preferred diagnostic test (50%). Testers were more likely to work in a busy practice (p=.048), more likely to report suspect cases (p=.003), and felt clinical judgment was not enough for diagnosis (p=.002). Testers incorrectly perceived PCR as standardized and reliable, and both groups perceived length of time to obtain results and availability of supplies as barriers to culture, although these findings were not significant.

Conclusions: Outreach to pediatricians regarding timely reporting, use of laboratory testing, and interpretation of results is necessary. Improved collaboration between pediatricians and Public Health is needed to facilitate diagnosis and control of pertussis in Georgia.