Sporadic Emergence Of Probable Cases Of Diphtheria

Abstract

Background: Vaccine preventable diseases still account for a large proportion of childhood morbidity and mortality in children less than five of age. The decline in immunization coverage over the years has worsened this resulting in the re-emergence of hitherto controlled infections such as diphtheria.

Objective: To review the presentation, management and outcome of cases of probable diphtheria seen at the children emergency centre at the Lagos University Teaching Hospital.

Methods: The hospital records of all cases of suspected diphtheria admitted from September 2007 to September 2008 were reviewed retrospectively. The biodata, presenting complaints, duration of complaints, immunization status, management and outcome were analyzed.

Results: Five cases of probable diphtheria were admitted during the study period. Two of the children died, two survived and one absconded. Three of the children had three doses each of diphtheria, pertussis and tetanus (DPT) toxoid immunization but none had the 18- month booster dose. Diphtheria specific antitoxin was not available for use in the management of any of the cases neither was bacteriological confirmation possible.

Conclusion: Efforts to increase immunization coverage rates should be intensified and a policy to include an 18-month booster dose as part of the routine immunization in the National Programme on Immunization may be beneficial. It is recommended that diphtheria specific antitoxin be made available in the country in the event of cases with similar presentation.