Risk factors for diphtheria: a prospective case-control study in the Republic of Georgia, 1995-1996.
The large-scale resurgence of diphtheria in the former Soviet Union offered a unique opportunity to evaluate risk factors for the transmission of respiratory diphtheria; therefore, a prospective case-control study was done in the republic of Georgia. In total, 218 diphtheria cases (hospitalized between October 1995 and March 1996) and 408 matched controls participated. One hundred cases (45%) were </=14 years of age, and 118 (55%) were >/=15 years of age (range: <1 to 75 years). In the multivariate analyses, the following risk factors were found to be significant: lack of vaccination (matched odds ratio [mOR]=19.2), household exposure to diphtheria (mOR=7.4), exposure to skin lesions (mOR=5.8), history of eczema (mOR=3.4), fever with myalgia prior to illness (mOR=2.6), having tonsils (mOR=4.4), sharing a bed (mOR=1.9), sharing cups and glasses (mOR=2.7), and taking a bath less than once a week (mOR=2.6). These findings emphasize primary prevention through immunizations, secondary prevention following exposure to diphtheria (and to suspicious skin lesions), and adherence to strict standards of personal hygiene.
Quick
M L
ML
Child Vaccine Preventable Disease Eradication Division and 2Division of Data Management, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, USA. maq2@cdc.gov
Sutter
R W
RW
Kobaidze
K
K
Malakmadze
N
N
Nakashidze
R
R
Murvanidze
S
S
Wooten
K G
KG
Strebel
P M
PM
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003353:Corynebacterium diphtheriae / Q000302:isolation & purification; D004165:Diphtheria / Q000382:microbiology / Q000635:transmission*; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D014611:Vaccination