Inflow Of Diphtheria Cases In a Tertiary Care Centre Prof. J.V Singh, Head Deptt. of Community Medicine CSM Medical University UP, Lucknow Dr. Saurabh Kashyap, JR-1 Deptt. of Community Medicine CSM Medical University UP, Lucknow
Introduction Diphtheria is an acute respiratory tract illness, caused by Cornynebacteriumdiphtheriae, a facultative anaerobic gram positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane (a pseudo membrane)on the tonsils, pharynx,and/or nasal cavity. A milder form of diphtheria can be restricted to the skin. Uncommon consequences include myocarditis (about 20% cases)and peripheral neuropathy(about 10% of cases).
Introduction Contd…… The current definition of diphtheria used by the Centers for Disease Control and Prevention (CDC) is based on both laboratory and clinical criteria. Laboratory criteria
Isolation of Corynebacteriumdiphtheriae from a clinical specimen, or
Histopathologic diagnosis of diphtheria
Upper respiratory tract illness with sore throat
Low-grade fever (>103°F is rare)
An adherent pseudomembrane of the tonsil(s), pharynx, and/or nose.
Probable: a clinically compatible case that is not laboratory-confirmed and is not epidemiologically linked to a laboratory-confirmed case
Confirmed: a clinically compatible case that is either laboratory-confirmed or epidemiologically linked to a laboratory-confirmed case
Objectives To study the inflow of diphtheria cases in a tertiary care hospital in last two months. To study the distribution of diphtheria cases (residence, age, sex, socioeconomic status, immunization pattern, occupation, education, religion and habitat).
METHODOLOGY Study site: The Department of Pediatrics CSMMU, Lucknow. Study design: A Case-series study Study duration: 2 months from 1st August to 30th September 2010. Study population: Clinically suspected case of diphtheria admitted in the hospital.
RESULTS AND OBSERVATIONS
Table-1: District Wise Distribution Of Diphtheria Cases And Vaccination Status
District wise distribution of the studied diphtheria cases and actual immunisation coverage (DLHS-3 2007-08)
Table 2: Age and Sex Distribution of Diphtheria Cases
Table 3: Socio-economic and Immunization status of Diphtheria cases
Table 4: Bio-social profile of families of the diphtheria cases
HABITAT OF DIPHTHERIA CASES
Conclusion The maximum cases were seen above 1 yr of age, out of which 33.63% were of above the age of 5 yrs. Maximum number of diphtheria cases (29.20%)were from Lucknow district. Majority (49.56%) of cases were unimmunized and 39.82%were partially immunized. 87% of the diphtheria cases were from rural background. The study shows predominance of diphtheria cases among males(59.30%) as compared to that of females(40.70%).
Conclusion…… 6. The number of diphtheria cases were more in lower socioeconomic class(74.34%) followed by lower middle class(17.70%). 7. Hindus were affected more(70.80%) than any other religion. 8. In 43.36% cases the Head of the family were illiterate. 9. 4 cases died while on treatment , out of which 1 died of rare complication (cardiomyopathy). 10. 2 patient left the hospital against medical advice and rest were discharged following improvement.