Diphtheria in Children-Are we even close to control the menace? Savaskar S.V.1, Bandichhode S.T.2, Chhajed P.S.3,* 1Professor & HOD, Dept. of Paediatrics, Dr. V.M. GMC, Solapur, Maharashtra 2Associate Professor, Dept. of Paediatrics, Dr. V.M. GMC, Solapur, Maharashtra 3Assistant Professor, Dept. of Paediatrics, Dr. V.M. GMC, Solapur, Maharashtra *Corresponding Author: Email: drpunitchhajed29@gmail.com
Online published on 23 February, 2018. Abstract Introduction Despite the success of mass immunization in many countries worldwide, diphtheria continues to play a major role as a lethal resurgent infectious disease. The case reports of resurgence/persistence of diphtheria in India represent only the tip of the iceberg. Aims and Objectives To study the epidemiology, clinical profile, complications and outcome of diphtheria in children. Materials and Method A retrospective observational study conducted at a teaching hospital. Review of case notes of all children aged 1 month-14 years, clinically/microbiologically diagnosed and managed as diphtheria was done. Demographic, clinical & immunization status details, complications and outcome were recorded. Results A total of 149 cases were reviewed. Male to female ratio was 1.26: 1. Maximum (65.77%) cases were reported from regions of Karnataka. Incidence of diphtheria was 0.4%. Highest incidence (46.98%) was seen in children of 5–10 years age group. Majority (69.80%) were unimmunized. Difficulty swallowing (89.93%) and bull neck (81.21%) were common presentations. A total of 79 complications were seen of which myocarditis was the commonest (41.77%). Of 149, 98 (65.77%) recovered and were successfully discharged. CFR was 29.53%. Maximum deaths (50%) were seen in 1–5 year age group. Most children (88.63%) died within 5 days of hospitalisation. Conclusion Even after more than 3 decades of UIP implementation, diphtheria is still not a lost entity. A shift in age incidence was observed. Occurrence in completely immunized children points towards waning immunity with age or flaws in immunization. Uniformity and improvement in vaccine coverage, adolescent/adult immunization and early diagnosis and treatment might take us closer to achieve control. Top Keywords Diphtheria, Vaccine preventable diseases, Resurgence, DTP3. Top |