Abstract: Objective To analyze the temporal trends in the disease burden of pertussis from 1990 to 2021 in China, globally, and across regions with varying Socio-demographic Index (SDI) levels, thereby providing an evidence base for the formulation of pertussis prevention and control strategies. Methods Data on the burden of pertussis for the period 1990-2021 for China, global regions, and different SDI quintiles were extracted from the Global Burden of Disease 2021 (GBD 2021) study. A Joinpoint regression model was employed to analyze the long-term temporal trends in the disease burden metrics. Results In 2021, the age-standardized incidence rate, prevalence rate, mortality rate, and Disability-Adjusted Life Years (DALY) rate of pertussis in China were 18.07, 2.48, 0.15, and 12.97 per 100 000 population, respectively. Over the period from 1990 to 2021, the age-standardized incidence, prevalence, mortality, and DALY rates for pertussis in China all demonstrated a significant declining trend, with Average Annual Percent Changes (AAPC) of -8.32% (95% CI: -9.15% to -7.49%), -8.33% (95% CI: -9.16% to -7.50%), -8.70% (95% CI: -11.14% to -6.20%), and -8.89% (95% CI: -11.58% to -6.13%), respectively. The disease burden of pertussis exhibited a trend of initially decreasing and subsequently increasing with age. The highest burden was observed in the under-5 age cohort, reaching its nadir in the 25-<30 age group, and then gradually increasing from the 30-<35 age group onwards. From 1990 to 2021, the overall burden of pertussis in China consistently surpassed that of high-SDI regions, while remaining lower than the global average as well as the burdens in middle, low-middle, and low-SDI regions. Conclusion Although the overall disease burden of pertussis in China exhibits a significant downward trend, it remains a considerable public health concern. It is imperative to enhance surveillance systems and deepen etiological research to more effectively control and prevent the transmission of pertussis.

Key words: Pertussis, Disease burden, Socio-demographic Index