The resurgence of diphtheria in Zinder, Niger

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES Infectious diseases now Pub Date : 2024-09-21 DOI:10.1016/j.idnow.2024.104979

Doutchi Mahamadou , Adamou Bara Abdoul-Aziz , Lamine Mahaman Moustapha , Diongolé Hassane , Souleymane Adoum Fils , Bagnou Hamsatou , George Thomas Abraham , Moussa Sahada , Hamadou Idrissa , Sani Ousmane , Ali Zaratou , Garba Abdoul Aziz , Ousmane Abdoulaye , Adehossi Eric , Serge Paul Eholié

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Abstract

Background

Diphtheria is a re-emerging bacterial disease in developing countries with low vaccination coverage.

Objectives

This is a descriptive cross-sectional study of diphtheria cases reported to the DRSP/Zinder from March 14, 2022 through June 26, 2023.

Methods

It includes cases reported through epidemiological surveillance and data on patients hospitalized in the infectious and tropical diseases department of the Zinder National Hospital (SMIT).

Results

A total of 32 patients were included in this study. The median age was 12 years [4–22 years]. Key symptoms included dysphagia and odynophagia (100 %), false membranes (84.4 %), fever (46.9 %), thrombocytopenia (39.3 %), cervical lymphadenopathy (37 %), respiratory distress (15.6 %), epistaxis (12.5 %), gingival bleeding (9.4 %), agitation (6.2 %) and paresis (3.1 %). Renal function was altered in 74 % of cases. Diagnostic confirmation was procured through culture on oropharyngeal swabs. Corynebacterium diphtheriae was isolated in 26.31 % (5/19) of cases. Patients were treated with macrolides and diphtheria antitoxin. The case fatality rate was 31.2 %. Poor prognostic factors included gingival bleeding (p = 0.0262), respiratory distress (p = 0.0374), and thrombocytopenia below 50,000 platelets/mm³ (p = 0.0020).

Conclusion

Diphtheria is a deadly re-emerging disease. The fight against this condition necessitates improved vaccination coverage.

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白喉在尼日尔津德尔再次流行。

背景：白喉是发展中国家再次爆发的细菌性疾病：在疫苗接种率较低的发展中国家，白喉是一种重新流行的细菌性疾病：这是一项描述性横断面研究，研究对象是2022年3月14日至2023年6月26日期间向DRSP/Zinder报告的白喉病例：方法：包括通过流行病学监测报告的病例以及在津德尔国立医院（SMIT）传染病和热带病科住院的患者数据：本研究共纳入 32 名患者。中位年龄为 12 岁 [4-22 岁]。主要症状包括吞咽困难和吞咽困难（100%）、假膜（84.4%）、发热（46.9%）、血小板减少（39.3%）、颈淋巴结病（37%）、呼吸困难（15.6%）、鼻衄（12.5%）、牙龈出血（9.4%）、烦躁不安（6.2%）和瘫痪（3.1%）。74%的病例出现肾功能改变。诊断确认是通过口咽拭子培养获得的。26.31%的病例（5/19）分离出白喉杆菌。患者接受了大环内酯类药物和白喉抗毒素治疗。病死率为 31.2%。不良预后因素包括牙龈出血（p = 0.0262）、呼吸困难（p = 0.0374）和血小板低于 50,000 个/mm3（p = 0.0020）：结论：白喉是一种致命的复发疾病。结论：白喉是一种致命的复发疾病，防治这种疾病需要提高疫苗接种覆盖率。

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