A Study on the Characteristics and Outcomes of Reported Diphtheria Patients in a Western State in India

Abstract

Background The incidence of diphtheria cases has declined significantly from 1,00,000 cases in 1980 to 2500 in 2015 globally. India contributed to half of the diphtheria cases reported globally from 2001 to 2015. The disease has higher case mortality and morbidity rate due to various geographic-specific factors. The current study aims to outline the characteristics and outcomes of the diphtheria-reported patients of Gujarat, a western state of India. Method A record-based, descriptive retrospective study was undertaken in the western state of India by analyzing district-wise reported diphtheria cases in diphtheria, tetanus, and pertussis (DPT) surveillance program format during 2020-2021. Result Out of 446, most patients were reported from selected geographies of Gujarat state in 2020-2021. The 424 (95%) reported cases were from 0-14 years of age. Only 9 (2%) subjects had a travel history, and 369 (82.7%) patients were reported from rural areas. The time trend analysis showed that 339 (76%) patients were reported from September to December. The case-fatality ratio was 5.4%, and 300 (67.2%) cases didn't take the DPT (DPT3)/pentavalent 3rd dose vaccine and subsequent doses during their lifetime, emphasizing the role of the vaccine in preventing diphtheria disease. Conclusion Increased vaccination coverage and completing all doses of the DPT vaccine are crucial to avert deaths due to diphtheria. An effective surveillance system will aid in early disease detection and provide more information on the factors that lead to disease occurrence for prompt action by the authority.

Keywords: diphtheria; disease surveillance; immunization; respiratory mucosa and skin; vaccine-preventable diseases.

Figure 1. Geographical distribution of diphtheria cases

Figure 2. Rural-urban distribution of diphtheria patients

Figure 3. Month-wise occurrence of diphtheria cases in 2020-21 (n=446)