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

• Published in: Epidemiology and infection Vol. 123; no. 2; pp. 209 - 215
• Main Authors: SINGH, J., HARIT, A. K., JAIN, D. C., PANDA, R. C., TEWARI, K. N., BHATIA, R., SOKHEY, J.
• Format: Journal Article
• Language: English
• Published: Cambridge Cambridge University Press 01.10.1999
• Subjects: Antitoxins; Bacteriology; Biological and medical sciences; Child; Child, Preschool; Children; Corynebacterium diphtheriae; Corynebacterium diphtheriae - isolation & purification; Diphtheria; Diphtheria - epidemiology; Diphtheria - mortality; Diphtheria - prevention & control; Diphtheria Toxoid - therapeutic use; Diseases; Dosage; Epidemiology; Female; Fundamental and applied biological sciences. Psychology; Hospitalization; Humans; India; India - epidemiology; Infant; Infectious diseases; Male; Microbiology; Mortality; Muslims; Seasons; Time Factors; Tropical medicine; Vaccination; Delhi; Asia; India; Human; Prevalence; Mortality; Corynebacterium diphtheriae; Diphtheria; Epidemiology; Infection; Follow up study; Seasonal variation; Bacteriosis; Bacteria; Actinomycetes; Corynebacteriaceae; Child
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268899002812

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.