title: Risk factors for diphtheria: a prospective case-control study in the Republic of Georgia, 1995-1996.
abstract: 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.
authors.affiliation: 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
authors.forename: M L
authors.initials: ML
authors.lastname: Quick
authors.forename: R W
authors.initials: RW
authors.lastname: Sutter
authors.forename: K
authors.initials: K
authors.lastname: Kobaidze
authors.forename: N
authors.initials: N
authors.lastname: Malakmadze
authors.forename: R
authors.initials: R
authors.lastname: Nakashidze
authors.forename: S
authors.initials: S
authors.lastname: Murvanidze
authors.forename: K G
authors.initials: KG
authors.lastname: Wooten
authors.forename: P M
authors.initials: PM
authors.lastname: Strebel
mesh_terms: 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