title: Diphtheria Re-emergence: Problems Faced by Developing Countries.
abstract: In the pre-vaccination era, diphtheria was a leading cause of childhood mortality. With the introduction of routine childhood immunization, paediatric care and improved hygiene status the disease has been almost completely eradicated in many developed countries. On the contrary developing countries, still account for 80-90% of the global burden. Retrospective analysis of 52 cases of diphtheria over a period of 12 years at a tertiary referral hospital was carried out. They were analyzed for mortality and morbidity trends, immunization status, microbiological confirmation rates and antidiphtheritic serum (ADS) administration. Incidence in those over 5 years was 59.61%. Only 11.54% cases were either partially or fully immunized. The case fatality rate was 36.53%. Culture was performed only in 17 cases whereas ADS was administered in only 16 cases. In conclusion, the occurrence of diphtheria even in those immunized highlights the flaws in the present immunization program. Poor immunization coverage, lack of ADS, antibiotic resistance are the main reasons for re-emergence of diphtheria.
authors.affiliation: Department of ENT, Karnataka Institute of Medical Sciences, Hubli, Karnataka India ; House No. 14, 1st Floor, 'Shreyas', Prabhat Colony, Vidyanagar, Hubli, 580021 Karnataka India.
authors.forename: Manjunath
authors.initials: M
authors.lastname: Dandinarasaiah
authors.affiliation: Department of ENT, Karnataka Institute of Medical Sciences, Hubli, Karnataka India.
authors.forename: Bhat Kemmannu
authors.initials: BK
authors.lastname: Vikram
authors.affiliation: Department of ENT, Karnataka Institute of Medical Sciences, Hubli, Karnataka India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Krishnamurthy
authors.affiliation: School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, 721302 West Bengal India.
authors.forename: A C
authors.initials: AC
authors.lastname: Chetan
authors.affiliation: Department of ENT, Karnataka Institute of Medical Sciences, Hubli, Karnataka India.
authors.forename: Abhineet
authors.initials: A
authors.lastname: Jain
keywords: Antidiphtheritic serum; Corynebacterium diphtheria; Immunization; Mortality; Re-emergence