Bridging gaps in critical pertussis care: A multinational survey of physicians' perspectives and practices

Abstract

Background: Pertussis remains a global health concern despite established vaccination programs, with critical or malignant pertussis presenting an ongoing challenge. In the Gulf Cooperation Council (GCC) region, data on physicians' knowledge and clinical management practices for severe pertussis are limited. Objectives: This study aimed to assess physicians' pertussis-related knowledge, attitudes, and management strategies in the GCC, focusing on critical pertussis cases and identifying predictors of higher knowledge levels. Methods: A cross-sectional, internet-based survey was conducted among pediatricians, intensivists, infectious disease specialists, and pulmonologists in the GCC between December 1, 2024, and January 31, 2025. Demographic information, clinical experience, diagnostic resources, and therapeutic approaches were collected. A multivariable generalized linear regression (Gamma) model identified factors associated with pertussis knowledge scores. Results 354 physicians completed the survey. Most respondents (91.2%) worked in governmental hospitals, and 45% had more than 10 years of practice. Only 31.1% reported a well-established protocol for managing hyperleukocytosis, and 8% had follow-up protocols after intensive care unit discharge. The mean knowledge score was 9.65 out of 13 (74.2%), indicating an overall moderate-to-high understanding of pertussis. However, knowledge gaps existed in transmission routes and prevention strategies. Infectious disease specialists (adjusted risk rate [aRR] 1.143, 95% confidence interval [CI] 1.073-1.217) and physicians with ≥16 years' experience (aRR 1.070, 95% CI 1.017-1.126) demonstrated higher knowledge levels. Most respondents (83.1%) endorsed standardized guidelines. Conclusions GCC physicians show moderate-to-high pertussis knowledge, yet critical gaps persist. Targeted educational initiatives and management guidelines are urgently needed to optimize clinical care and follow-up of critical pertussis, ultimately improving patient outcomes. © 2025 Elsevier B.V., All rights reserved.