title: Diphtheria is declining but continues to kill many children: analysis of data from a sentinel centre in Delhi, 1997.
abstract: 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.
authors.affiliation: National Institute of Communicable Diseases, Delhi, India.
authors.forename: J
authors.initials: J
authors.lastname: Singh
authors.forename: A K
authors.initials: AK
authors.lastname: Harit
authors.forename: D C
authors.initials: DC
authors.lastname: Jain
authors.forename: R C
authors.initials: RC
authors.lastname: Panda
authors.forename: K N
authors.initials: KN
authors.lastname: Tewari
authors.forename: R
authors.initials: R
authors.lastname: Bhatia
authors.forename: J
authors.initials: J
authors.lastname: Sokhey
mesh_terms: D002648:Child; D002675:Child, Preschool; D003353:Corynebacterium diphtheriae / Q000302:isolation & purification; D004165:Diphtheria / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D004168:Diphtheria Toxoid / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D012621:Seasons; D013997:Time Factors
chemical_list: D004168:Diphtheria Toxoid