Publication:

A cross sectional study on clinical profile and complications associated with diphtheria in Sir Ronald Ross Institute of Tropical and Communicable diseases, Hyderabad, Telangana state

Background Diphtheria is a potentially fatal infection caused by Corynebacterium (C.) diphtheriae strains and occasionally by toxigenic C. ulcerans and C. pseudotuberculosis strains. Although effective vaccines are available all over the world, this disease has the potential to re-emerge. As there are few studies regarding clinical profile, complications, and immunization status among adult in Telangana, this study will bridge the gap in information regarding demographic data, clinical features, immunization status, and the presence of complications.

Methods Cross sectional study done for a period of 8 months from March-October 2019 at Sir Ronald Ross Institute of Tropical and Communicable Diseases, Hyderabad. Study was done on 150 diphtheria (clinical and microbiologically) positive cases admitted. The collected data was entered in Microsoft excel and analysed using Epi info v.7.2.6.6.

Results Out of the total study participants 34% belong to 10-14 years age group 99.3% had patch over tonsil, 98.7% had fever. Among the study participants, 19.3% had electrocardiography (ECG) abnormalities, 10.7% had breathing problems, 11.3% had both ECG abnormalities and breathing problems, 7.3% had diphtheria myocarditis. 20.7% were completely immunized and 46% were partially immunized, 6.6% patient’s immunization status were unknown and 26.7% of the patients were unvaccinated. The occurrence of complications was common among Muslims (p=0.001), rural residence (p=0.0005). Educational qualification was significantly associated with occurrence of complications (p=0.04), and people coming from lower socioeconomic strata had more complications compared to others (p≤0.05) Unvaccinated people suffered from more complications compared to vaccinated people (p=0.002).

Conclusions There is an age shift in the occurrence of diphtheria increasingly over 5 years of age.