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Diphtheria resurgence in Sada'a-Yemen, 2017–2020

BACKGROUND: Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe th...

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Autores principales: Al-Dar, Ahmed Abdallah, Al-Qassimi, Mutahar, Ezzadeen, Faten Hamid, Qassime, Mohammed, Al murtadha, Ahmed Mohamed, Ghaleb, Yasser
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751122/
https://www.ncbi.nlm.nih.gov/pubmed/35016630
http://dx.doi.org/10.1186/s12879-022-07033-x
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author Al-Dar, Ahmed Abdallah
Al-Qassimi, Mutahar
Ezzadeen, Faten Hamid
Qassime, Mohammed
Al murtadha, Ahmed Mohamed
Ghaleb, Yasser
author_facet Al-Dar, Ahmed Abdallah
Al-Qassimi, Mutahar
Ezzadeen, Faten Hamid
Qassime, Mohammed
Al murtadha, Ahmed Mohamed
Ghaleb, Yasser
author_sort Al-Dar, Ahmed Abdallah
collection PubMed
description BACKGROUND: Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. METHODS: A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. RESULTS: 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). CONCLUSIONS: The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.
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spelling pubmed-87511222022-01-11 Diphtheria resurgence in Sada'a-Yemen, 2017–2020 Al-Dar, Ahmed Abdallah Al-Qassimi, Mutahar Ezzadeen, Faten Hamid Qassime, Mohammed Al murtadha, Ahmed Mohamed Ghaleb, Yasser BMC Infect Dis Research BACKGROUND: Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. METHODS: A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. RESULTS: 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). CONCLUSIONS: The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts. BioMed Central 2022-01-11 /pmc/articles/PMC8751122/ /pubmed/35016630 http://dx.doi.org/10.1186/s12879-022-07033-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Al-Dar, Ahmed Abdallah
Al-Qassimi, Mutahar
Ezzadeen, Faten Hamid
Qassime, Mohammed
Al murtadha, Ahmed Mohamed
Ghaleb, Yasser
Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title_full Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title_fullStr Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title_full_unstemmed Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title_short Diphtheria resurgence in Sada'a-Yemen, 2017–2020
title_sort diphtheria resurgence in sada'a-yemen, 2017–2020
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751122/
https://www.ncbi.nlm.nih.gov/pubmed/35016630
http://dx.doi.org/10.1186/s12879-022-07033-x
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