Diphtheria outbreak in Nigeria: lessons from the past for the challenges ahead

Abstract

On January 20, 2023, the Nigerian Ministry of Health and other pertinent health organizations declared a diphtheria outbreak. As of Friday, 25 individuals had reportedly died in the case. The most affected group was children. One of the hardest-hit areas is Nigeria's northern state [1] .The precise number of incidents and fatalities has not yet been verified. Four of the 36 states that have been severely impacted by the outbreak are being monitored by the Centres for Disease Control and Prevention, Nigeria, which has set up an emergency response. The objective of this correspondence article is to evaluate the epidemiological distribution of diphtheria in Nigeria. The etiology of diphtheria concerns "Corynebacteria," the species most harmful concerning Corynebacterium diphtheria, which creates poisons modulating a contagion of public health concern. Corynebacterium diphtheria is a gram-positive, noncapsulated, nonmotile, and club-shaped bacteria [2] . Corynebacterium pseudotuberculosis and Corynebacterium ulcerans are 2 further noteworthy but uncommon strains.The paralysis of the soft palate and throat muscles, ulcerating skin lesions, and the membrane's expansion into the trachea and larynx, leading to airway obstruction and myocarditis, are all complications of diphtheria [2] . Diphtheria cases decreased from ~1,000,000 annually to an average of 6582 between 2013 and 2017 globally, thanks to the advent of the diphtheria toxoid (DPT) vaccine in the 1950s [2,3] . Beginning in the 1990s, Russia carried the largest global burden [2] . Like other African nations, Nigeria underreports cases. In 2011, there were 98 instances in

Sociological interventions for the diphtheria outbreak in Nigeria: addressing misconceptions, cultural biases, and promoting vaccination

“…Antitoxin is also administered to neutralize the toxins, produced by the bacteria. If left untreated, diphtheria can lead to severe complications, including heart problems, nerve damage, and difficulty breathing, which can be life-threatening [19].…”

“…Public Health Campaigns: Government health agencies, such as the Nigeria Centre for Diseases Control and Prevention (NCDC) and Nigerian Ministry of Health, have led public health campaigns to educate the public about diphtheria. These campaigns include posters, brochures, and advertisements on television, radio, and social media, but the fact is that the campaigns have remained limited in coverage across Nigeria, especially in rural areas [16,19].…”

“…It can also spread through contact with contaminated objects [18]. Diphtheria, though a preventable and vaccine-preventable disease, still poses a significant public health threat in Nigeria due to challenges, associated with misconceptions, cultural biases, and vaccine hesitancy [19][20][21]. The Nigeria Centre for Disease Control and Prevention (NCDC) first alerted the public to the outbreak of diphtheria in the country in December 2022 [18].…”

Understanding the Trend of Diphtheria Outbreak in Nigeria from 1941-2023: A Narrative Review

“…The most pathogenic species, Corynebacterium diphtheria, is divided into three strains that can be identified and differentiated on tellurite agar (2). The Corynebacterium diphtheriae gravis (3-5m), Corynebacterium diphtheriae mitis 2-4mm, and Corynebacterium diphtheriae intermedius (1-2mm) strains.…”

Diphtheria outbreak in Nigeria: what we know now

“…However, these symptoms depend on the part of the body that is affected. Symptoms develop within 2–5 days of onset in symptomatic patients [ 1 , 2 ]. Corynebacterium diphtheriae primarily infect the respiratory tract (throat, pharynx and nose) by attaching to the lining of the respiratory tract and releasing an extracellular protein called diphtheria toxin (DT) [ 3 , 4 ].…”