Diphtheria outbreak in a district in Meghalaya, India: an overview

Bhattacharyya, Himashree; Sarkar, Amrita; Medhi, Gajendra Kumar; Pala, Star

doi:10.18203/2394-6040.ijcmph20163951

Cited by 5 publications

(4 citation statements)

References 5 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diphtheria outbreaks often occur because of low childhood vaccination, as well as lack of booster vaccinations for older children and adults [17]. This supports our findings that most affected cases were unvaccinated, which is consistent with the findings of previous studies in India and Indonesia reporting that mortality occurred in more than 70% of patients who did not receive complete immunization [14,18].…”

Section: Principal Findingssupporting

confidence: 92%

Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis

Moghalles¹,

Aboasba²,

Alamad³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

Background As a consequence of war and the collapse of the health system in Yemen, which prevented many people from accessing health facilities to obtain primary health care, vaccination coverage was affected, leading to a deadly diphtheria epidemic at the end of 2017. Objective This study aimed to describe the epidemiology of diphtheria in Yemen and determine its incidence and case fatality rate. Methods Data were obtained from the diphtheria surveillance program 2017-2018, using case definitions of the World Health Organization. A probable case was defined as a case involving a person having laryngitis, pharyngitis, or tonsillitis and an adherent membrane of the tonsils, pharynx, and/or nose. A confirmed case was defined as a probable case that was laboratory confirmed or linked epidemiologically to a laboratory-confirmed case. Data from the Central Statistical Organization was used to calculate the incidence per 100,000 population. A P value <.05 was considered significant. Results A total of 2243 cases were reported during the period between July 2017 and August 2018. About 49% (1090/2243, 48.6%) of the cases were males. About 44% (978/2243, 43.6%) of the cases involved children aged 5 to 15 years. Respiratory tract infection was the predominant symptom (2044/2243, 91.1%), followed by pseudomembrane (1822/2243, 81.2%). Based on the vaccination status, the percentages of partially vaccinated, vaccinated, unvaccinated, and unknown status patients were 6.6% (148/2243), 30.8% (690/2243), 48.6% (10902243), and 14.0% (315/2243), respectively. The overall incidence of diphtheria was 8 per 100,000 population. The highest incidence was among the age group <15 years (11 per 100,000 population), and the lowest incidence was among the age group ≥15 years (5 per 100,000 population). The overall case fatality rate among all age groups was 5%, and it was higher (10%) in the age group <5 years. Five governorates that were difficult to access (Raymah, Abyan, Sa'ada, Lahj, and Al Jawf) had a very high case fatality rate (22%). Conclusions Diphtheria affected a large number of people in Yemen in 2017-2018. The majority of patients were partially or not vaccinated. Children aged ≤15 years were more affected, with higher fatality among children aged <5 years. Five governorates that were difficult to access had a case fatality rate twice that of the World Health Organization estimate (5%-10%). To control the diphtheria epidemic in Yemen, it is recommended to increase routine vaccination coverage and booster immunizations, increase public health awareness toward diphtheria, and strengthen the surveillance system for early detection and immediate response.

show abstract

Section: Principal Findingssupporting

confidence: 92%

Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis

Moghalles¹,

Aboasba²,

Alamad³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…The antisera were later developed by the Pasteur Institute through a large-scale experiment in 1894 in Paris where there was a mortality rate of 24.5% in 448 children given diphtheria antitoxin therapy, and mortality reached 60% in 520 children who were not given diphtheria antitoxin therapy [11]. This is consistent with Himashree (2016) study in Meghalaya India, a significant cause of severity in 7 diphtheria patients in the region was the absence of diphtheria antitoxin, and the severity was exacerbated by low immunization status, socioeconomic status and community awareness and behaviour towards health and search for treatment [12].…”

Section: Discussionsupporting

confidence: 80%

“…The most dominant variable associated with a decrease in severity is the administration of DAT with an OR of 4,063 (95% CI: 1,354- 12,195), meaning that patients with diphtheria who get DAT are 4 (four) times more likely to experience the decreasing of diphtheria severity.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Diphtheria AntiToxin (DAT) to Decrease Degrees of Diphtheria Severity

2020

AIDT

View full text Add to dashboard Cite

Background: Diphtheria incidence and mortality in Indonesia continue to increase from 2014-2017. DAT is critical to reduce the severity of diphtheria. The study aimed to determine the effect of DAT on reducing severity in diphtheria patients. Method: Analytical research with a case-control design. The research was conducted at RSPI Prof. Dr. Sulianti Saroso. The sample in this study was patients diagnosed with suspected diphtheria and diphtheria who received inpatient care at RSPI SS within a period of four years from 2014 to 2017. The cases in this study were 86 diphtheria-treated patients who were treated for 86 days, controls were 86 diphtheria-treated patients who were treated for <10 days. Data were collected from medical records. Results: the variable associated with a decrease in severity of diphtheria sufferers was DAT (OR = 4,063; 95% CI: 1,354- 12,195, p = 0.012), corticosteroid administration (OR = 3,653, 95% CI 1.568-8,513, p = 0.003) and culture (OR = 0.170; 95% CI: 0.054-0,547), myocarditis is a confounding variable (OR = 1,690; 95% CI: 0.565- 5,052, p = 0.348). Conclusion: Provision of DAT has been shown to affect decreasing the severity of diphtheria.

show abstract

“…5 Bhattacharya et al reported a case on outbreak of diphtheria where the mean age group was 10.23 years with male preponderance of 53.33% and case fatality rate of 28.6%. 6 Our study reported a case fatality rate of 8.2%. Study conducted in Hyderabad during 2003 to 2006 also noted a highest incidence among children aged 5 to 19 years.…”

Section: Discussionmentioning

confidence: 59%

Laryngeal diphtheria: still a problem

Ali

Devi

Meher

et al. 2020

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: Globally diphtheria has been showing a declining trend due to effective childhood vaccination programmes. However, inadequate healthcare delivery systems and other social factors have led to diphtheria re-emerging and remaining endemic in many regions of the world. Securing airway by emergency tracheostomy plays a pivotal role in the management of laryngeal diphtheria in addition to antitoxin.Methods: This was a retrospective study conducted in Department of ENT, Maulana Azad Medical College from January 2015 to December 2018. The study included cases of diphtheria with stridor or impending airway obstruction. The information collected included age, gender, socioeconomic status and immunization status. The month of presentation was noted to establish the seasonal trend of the infection. Results: Maximum number of cases was in the age group of 3 to 9 years (62.3% of total cases). Male children predominated over female children with overall sex ratio of 3:1. Most of the cases presenting to us were partially immunized (51.8%) or unimmunized (44.6%). The maximum number of cases was reported in the month of August to November (96 out of 122 cases). Emergency tracheostomy was done in 86.9% (106 out of 122 cases).Conclusions: Diphtheria still continues to be a major public health issue in India. Early recognition and treatment are necessary to prevent morbidities and mortalities. Tracheostomy is a speedy and efficient lifesaving procedure in the management of laryngeal diphtheria.

show abstract

Diphtheria outbreak in a district in Meghalaya, India: an overview

Cited by 5 publications

References 5 publications

Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis

Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis

The Effect of Diphtheria AntiToxin (DAT) to Decrease Degrees of Diphtheria Severity

Laryngeal diphtheria: still a problem

Contact Info

Product

Resources

About