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Dr Saurabh Kashyap


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Dr Saurabh Kashyap

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