Outcomes of respiratory diphtheria in a tertiary referral infectious disease hospital

Abstract

diphtheria is still a public health problem in many developing countries. Strict public health measures like an increased immunization coverage, improvement of socio-economic status, easy availability of anti-diphtheritic serum (ADS), early recognition and effective treatment-all may reduce the incidence and mortality.

Obstinate diphtheria needs innovation in immunization

“…11 Kole AK et al observed male preponderance of cases below 10 years, whereas female preponderance was seen above 20 years. 12 Basavaraja GV et al also noted in their study that females (51.6%) over numbered the males. 13 In contrast Maheriya KM et al reported male dominance with 1.833:1 male to female ratio.…”

“…Kole AK et al reported that most common affected age group was children of 5 to 10 years (35%). 12 Basavaraja GV et al also observed 74.1% cases above the age of 5 years. 13 There is an age shift in the occurrence of diphtheria recently in our country and 40-45% was above the age of 5 years.…”

“…Kole AK et al found 50% of the diphtheria patients belonged to lower socioeconomic status. 12 Maheriya KM et al reported 47.0% rural cases and 76.3% from lower socioeconomic class. 16 Peak in autumn as revealed from current study was also observed by Maheriya KM et al who reported that great number of increase was seen during month of August to month of December.…”

“…13 In contrast Maheriya KM et al reported male dominance with 1.833:1 male to female ratio. 12,13,16 Analysis reflected that higher proportion of diphtheria patients belonged to BPL category which could be attributed to the fact that rural patients outnumbered their urban counterpart which in turn might be because rural population constitutes almost of 70% of our population. Poor immunization coverage in rural area as well as low environmental condition and nutritional status arising out of lower socioeconomic class favoured transmission and persistence of Corynaebacterium diphtheriae among their community.…”

“…12 Maheriya KM et al reported that pain in throat and fever were universal. 16 Current study revealed Myocarditis as the most common complication observed in 40.87% of cases compared to a higher rate of 68% cases reported by Kole AK et al 12 The current study reported low case fatality rate of 3.97% which was concurrent to 3.33%, 1.2% and 2.5% reported by Nath B et al, Bitragunta S et al and Kole AK et al [10][11][12] In 2013, India experience case fatality rate (CFR) of 2.61% for diphtheria. 5 However, higher rates of 41.0% and 23.67% were shown by Basavaraja GV et al and Maheriya KM et al 13,16 The higher CFR was due to delayed treatment, specially with ADS.…”