# Epidemiology of pertussis in Saudi Arabia (2006–2023): regional variations and COVID-19 effects

## TL;DR

This study analyzed pertussis trends in Saudi Arabia from 2006 to 2023, finding regional and age-related variations in incidence, with a notable rise during the pandemic and in 2023.

## Contribution

The study provides a detailed epidemiological analysis of pertussis in Saudi Arabia, highlighting regional disparities and the impact of the COVID-19 pandemic.

## Key findings

- Pertussis incidence increased in 2019 and rebounded in 2023 after declining during the pandemic.
- Children aged 0–4 years had the highest incidence rates, and Qassim and Aseer regions reported the highest crude incidence rates.
- Saudi nationals had a 3.6 times higher crude incidence rate compared to non-Saudis.

## Abstract

Pertussis remains a public health concern. This study investigated the epidemiology of pertussis in Saudi Arabia from 2006 to 2023 by examining trends in case numbers and crude incidence rates (CIR) by year, age group, region, sex, and nationality. Particular attention was given to the rise in cases during the COVID-19 pandemic (2019–2020) and its resurgence in 2023.

A retrospective analysis was conducted using pertussis data reported across 20 regions of Saudi Arabia between January 2006 and December 2023 obtained from the Statistical Yearbooks of the Saudi Ministry of Health. Statistical analyses were performed using SPSS version 20.0, and both parametric and nonparametric methods were applied.

The incidence of pertussis showed marked fluctuations, with a sharp increase in 2019 (CIR: 0.75/100,000), a decline in 2020–2022, and a rebound in 2023 (CIR: 0.30/100,000). The highest CIRs were recorded for Qassim (0.36), Aseer (0.29), Taif (0.28), and Al-Ahsa (0.25). Regions such as Al-Baha, Jouf, and Qurayyat have reported negligible or no cases. Children aged 0–4 years accounted for the highest incidence (3.4/100,000), whereas older age groups had substantially lower rates. The male-to-female ratios were nearly equal (1.1:1 for Saudis and 1:1 for non-Saudis). Overall, the CIR in Saudi nationals was 3.6 times higher than that in non-Saudis.

The incidence of pertussis in Saudi Arabia varies by age and region, with the greatest burden observed in young children and in regions such as Qassim and Aseer. These findings underscore the importance of targeted vaccination strategies and sustained public health efforts to address these disparities and protect vulnerable populations.