Diphtheria is declining but continues to kill many children: analysis of data from a sentinel centre in Delhi, 1997

Abstract

Although diphtheria is declining in Delhi, case fatality rates (CFRs) are rising. In 1997, of 143 clinically suspected cases admitted to the Infectious Diseases Hospital 45 (32%) died. We examined their records to understand the epidemiology and reasons for high CFRs. About 53% of cases were from Delhi; they were not limited to any particular area. All the deaths and 92% (131/143) of cases occurred in children below 10 years of age. Only 12% of cases had received one or more doses of DPT. Muslims contributed significantly more cases than Hindus. CFRs were significantly higher in young (P = 0.03) and unvaccinated (P = 0.01) children and in those who received antitoxin on the third day of illness or later (P = 0.03). The study highlights the importance of improved vaccine coverage and early diagnosis and prompt administration of antitoxin in reducing CFRs for diphtheria in Delhi.

A study on dog bite incidence in Union Territory of Dadra & Nagar Haveli, India

“…Few prior studies have investigated in different part of world from different point of view, the mortality and severity of dog bite injuries (Hansen, 1973;Morr et al, 1977;Sosin et al, 1992;Weiss andCoben, 1995 andSacks et al, 1996), epidemiological study of rabies (Langley, 1992;Knobel et al, 2005). In Indian scenario, selected workers have indicated the incidence of dog bite and rabies in different part of the country as like Sudarshan et al, 2006 and2007. Similarly, studies have been done in selected cities like Delhi (Singh et al, 2001 andGohil et al, 2003) and Bangalore (Sudarshan et al, 1995) The available literature indicates that there is no published report available on the incidence of dog bite in the Union …”

Diphtheria remains a threat to health in the developing world: an overview

“…In developing countries, high levels of vaccination of infants with diphtheria-tetanus toxoids-pertussis vaccine (DTP) Despite the widespread use of immunization, diphtheria remains endemic in several regions (Galazka & Robertson 1995) including Africa, India (Singh et al 1999), Bangladesh, Vietnam (Kneen et al 1998), the tropics and areas of South America (Cárdenas et al 1972, MacQueen 1997, including Brazil (Formiga 1985). Several countries where coverage has been high for 5-10 years have reported diphtheria outbreaks.…”

“…Although adolescents and adults made up a majority of reported cases during the NIS epidemic, diphtheria continues to kill many children in industrialized and developing countries (Singh et al 1999).…”

Diphtheria Re-emergence: Problems Faced by Developing Countries

“…Case fatality rate in the present study was 36.53% where as it ranged from 32 to 56.3% in different centers in north India [9,18,21], and 42.9% in west India [22]. This higher case fatality was attributed to non availability of antitoxin in India [7,18,21,23].…”

“…This higher case fatality was attributed to non availability of antitoxin in India [7,18,21,23]. This may also be due to delay in diagnosing the cases.…”