Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context
Summary: Background: The COVID 19 pandemic led to significant disruptions in health services, including immunisation programs, which contributed to a major post-pandemic diphtheria outbreak in Kano State, Nigeria. This region accounted for 85% of the nation's documented diphtheria cases. Metho...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | EBioMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396425003214 |
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| author | Muhammad Adamu Abbas Abubakar Labaran Yusuf Hassan Adam Murtala Aisha Adam Abdullahi Adam Muhammad Murtala Jordi Bertran Torrelles Muktar Hassan Aliyu Hamisu Mohammed Salihu |
| author_facet | Muhammad Adamu Abbas Abubakar Labaran Yusuf Hassan Adam Murtala Aisha Adam Abdullahi Adam Muhammad Murtala Jordi Bertran Torrelles Muktar Hassan Aliyu Hamisu Mohammed Salihu |
| author_sort | Muhammad Adamu Abbas |
| collection | DOAJ |
| description | Summary: Background: The COVID 19 pandemic led to significant disruptions in health services, including immunisation programs, which contributed to a major post-pandemic diphtheria outbreak in Kano State, Nigeria. This region accounted for 85% of the nation's documented diphtheria cases. Methods: This study examined the epidemiology, clinical characteristics, and mortality outcomes of cases diagnosed between February 2022 and April 2024. Data were collected through the Surveillance Outbreak Response Management and Analysis System (SORMAS), and case definitions followed WHO guidelines. Case fatality rate (CFR) was calculated, and a logistic regression model was used to assess mortality-related risk factors, reporting adjusted odds ratios (AOR). Findings: A total of 18,320 cases were analysed, with the outbreak showing a bimodal distribution. The primary peak occurred in August 2023, followed by a smaller secondary peak in early 2024. The case fatality rate (CFR) was 4.5%. Patients who were not vaccinated had more than double the likelihood of death compared to fully vaccinated individuals (AOR 2.45; 95% CI: 2.05, 2.94, p < 0.0001; logistic regression). Similarly, patients without vaccination documentation also had greater odds, with more than 87% increase likelihood of mortality compared to fully vaccinated individuals (AOR 1.87, 95% CI: 1.27, 2.68, p < 0.0001; logistic regression). Interpretation: Our study reinforces previous reports of the weakening preventive health delivery systems in resource constrained settings, particularly after the disruptions caused by the COVID 19 pandemic leading to the resurgence of vaccine preventable diseases, such as diphtheria. These highlight the need for improved vaccination coverage and surveillance systems. Fundings: This research did not receive any external funding. |
| format | Article |
| id | doaj-art-39ab09de4c874cbb8ef5a52f99ffae5d |
| institution | Kabale University |
| issn | 2352-3964 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj-art-39ab09de4c874cbb8ef5a52f99ffae5d2025-08-20T03:38:23ZengElsevierEBioMedicine2352-39642025-08-0111810587710.1016/j.ebiom.2025.105877Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in contextMuhammad Adamu Abbas0Abubakar Labaran Yusuf1Hassan Adam Murtala2Aisha Adam Abdullahi3Adam Muhammad Murtala4Jordi Bertran Torrelles5Muktar Hassan Aliyu6Hamisu Mohammed Salihu7Kano Center for Disease Control and Prevention, Nigeria; Department of Community Medicine, Bayero University Kano, NigeriaOffice of the Commissioner for Health, Kano State Ministry of Health, Kano, Nigeria; Department of Medicine, Federal University Dutse, NigeriaDepartment of Epidemiology & Population Health, Kano Independent Research Centre Trust, NigeriaDepartment of Epidemiology & Population Health, Kano Independent Research Centre Trust, NigeriaDepartment of Epidemiology & Population Health, Kano Independent Research Centre Trust, NigeriaI-CARE, Texas Biomedical Research Institute, San Antonio, Houston, TX, USAVanderbilt Institute for Global Health, Vanderbilt University Medical Centre, USADepartment of Epidemiology & Population Health, Kano Independent Research Centre Trust, Nigeria; Corresponding author.Summary: Background: The COVID 19 pandemic led to significant disruptions in health services, including immunisation programs, which contributed to a major post-pandemic diphtheria outbreak in Kano State, Nigeria. This region accounted for 85% of the nation's documented diphtheria cases. Methods: This study examined the epidemiology, clinical characteristics, and mortality outcomes of cases diagnosed between February 2022 and April 2024. Data were collected through the Surveillance Outbreak Response Management and Analysis System (SORMAS), and case definitions followed WHO guidelines. Case fatality rate (CFR) was calculated, and a logistic regression model was used to assess mortality-related risk factors, reporting adjusted odds ratios (AOR). Findings: A total of 18,320 cases were analysed, with the outbreak showing a bimodal distribution. The primary peak occurred in August 2023, followed by a smaller secondary peak in early 2024. The case fatality rate (CFR) was 4.5%. Patients who were not vaccinated had more than double the likelihood of death compared to fully vaccinated individuals (AOR 2.45; 95% CI: 2.05, 2.94, p < 0.0001; logistic regression). Similarly, patients without vaccination documentation also had greater odds, with more than 87% increase likelihood of mortality compared to fully vaccinated individuals (AOR 1.87, 95% CI: 1.27, 2.68, p < 0.0001; logistic regression). Interpretation: Our study reinforces previous reports of the weakening preventive health delivery systems in resource constrained settings, particularly after the disruptions caused by the COVID 19 pandemic leading to the resurgence of vaccine preventable diseases, such as diphtheria. These highlight the need for improved vaccination coverage and surveillance systems. Fundings: This research did not receive any external funding.http://www.sciencedirect.com/science/article/pii/S2352396425003214DiphtheriaOutbreakEpidemiologyNigeriaVaccine preventable diseases |
| spellingShingle | Muhammad Adamu Abbas Abubakar Labaran Yusuf Hassan Adam Murtala Aisha Adam Abdullahi Adam Muhammad Murtala Jordi Bertran Torrelles Muktar Hassan Aliyu Hamisu Mohammed Salihu Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context EBioMedicine Diphtheria Outbreak Epidemiology Nigeria Vaccine preventable diseases |
| title | Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context |
| title_full | Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context |
| title_fullStr | Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context |
| title_full_unstemmed | Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context |
| title_short | Post COVID 19 resurgence of diphtheria in Kano, Nigeria: analysis of 18,320 casesResearch in context |
| title_sort | post covid 19 resurgence of diphtheria in kano nigeria analysis of 18 320 casesresearch in context |
| topic | Diphtheria Outbreak Epidemiology Nigeria Vaccine preventable diseases |
| url | http://www.sciencedirect.com/science/article/pii/S2352396425003214 |
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