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

Published online by Cambridge University Press:  01 October 1999

J. SINGH
Affiliation:
National Institute of Communicable Diseases, 22 Shamnath Marg, Delhi-110054, India
A. K. HARIT
Affiliation:
National Institute of Communicable Diseases, 22 Shamnath Marg, Delhi-110054, India
D. C. JAIN
Affiliation:
National Institute of Communicable Diseases, 22 Shamnath Marg, Delhi-110054, India
R. C. PANDA
Affiliation:
Infectious Diseases Hospital, G. T. B. Nagar, Delhi-110009, India
K. N. TEWARI
Affiliation:
Director of Health Services-cum-Municipal Health Officer, Municipal Corporation of Delhi, Town Hall, Delhi-110006, India
R. BHATIA
Affiliation:
National Institute of Communicable Diseases, 22 Shamnath Marg, Delhi-110054, India
J. SOKHEY
Affiliation:
National Institute of Communicable Diseases, 22 Shamnath Marg, Delhi-110054, India
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Abstract

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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.

Type
Research Article
Copyright
© 1999 Cambridge University Press