Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria

Abstract Background Frequent outbreak of diphtheria occurs in Nigeria and some developing nations due to poverty, poor environmental sanitation, and vaccination coverage. Aim To determine the clinical presentation and outcome of diphtheria in cases admitted in a Yobe Specialist Hospital Potiskum, Yo...

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Main Authors: Ballah Akawu Denue, Rakiya Mohammed Ngoshe, Habu Abdul, Cecilia Balla Akawu, Mohammad Lawan Gana, Anas Yusuf Hussaini, Ajayi Babajide Bamidele
Format: Article
Language:English
Published: SpringerOpen 2024-11-01
Series:The Egyptian Journal of Internal Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43162-024-00372-y
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author Ballah Akawu Denue
Rakiya Mohammed Ngoshe
Habu Abdul
Cecilia Balla Akawu
Mohammad Lawan Gana
Anas Yusuf Hussaini
Ajayi Babajide Bamidele
author_facet Ballah Akawu Denue
Rakiya Mohammed Ngoshe
Habu Abdul
Cecilia Balla Akawu
Mohammad Lawan Gana
Anas Yusuf Hussaini
Ajayi Babajide Bamidele
author_sort Ballah Akawu Denue
collection DOAJ
description Abstract Background Frequent outbreak of diphtheria occurs in Nigeria and some developing nations due to poverty, poor environmental sanitation, and vaccination coverage. Aim To determine the clinical presentation and outcome of diphtheria in cases admitted in a Yobe Specialist Hospital Potiskum, Yobe State, North-East Nigeria. Methods This is an observational study involving consecutive cases of diphtheria admitted in diphtheria treatment unit (DTU) in the hospital. Cases were admitted from 27th May to 30th October 2023. Results A total of 640 patients were admitted with median age of 9 (1–62), with males constituting 350 (54.6%). Only 9 (1)% of patients had vaccination. Common clinical features included pseudomembrane (90.7%), fever (79.7%), neck pain (78.3%), gross cervical lymphadenopathy (GCL; 69.1%), and sore throat (44.2%). The case fatality rate was 7%, higher in < 5 years (8.4%) than 5–14 years (7.4%) and ≥ 15 years (2.2%) respectively. Independent risk for fatality included delay in presentation (adjusted odd ratio (AOR) = 1.21, 95% confidence interval (CI) [1.10, 1.42], p < 0.001), vomiting (AOR = 3.6, 95% CI [1.36, 9.6], p = 0.01), bleeding from orifices (AOR = 3.76, 95% CI [5.76, 6.98], p < 0.001), blood transfusion (AOR = 8.12, 95% CI [3.34, 19.74], p < 0.001), and diphtheria antitoxin (DAT) administration (AOR = 3.17, 95% CI [1.37, 7.25], p = 0.07). Conclusion Clinical presentation was consistent with diphtheria. Risk of fatality included vomiting, bleeding from orifices, anemia necessitating blood transfusion, delay in presentation, and DAT administration.
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spelling doaj-art-7e08e0c4cdab4bf98c45312959b874ba2025-08-20T02:33:05ZengSpringerOpenThe Egyptian Journal of Internal Medicine2090-90982024-11-013611710.1186/s43162-024-00372-yClinical presentation and outcome of diphtheria in health facility in North-East NigeriaBallah Akawu Denue0Rakiya Mohammed Ngoshe1Habu Abdul2Cecilia Balla Akawu3Mohammad Lawan Gana4Anas Yusuf Hussaini5Ajayi Babajide Bamidele6Department of Medicine, College of Medical Sciences, University of MaiduguriDepartment of Medicine, Nile UniversityDepartment of Medicine, Yobe State UniversityDepartment of Geography, University of MaiduguriDepartment of Community Medicine, Yobe State UniversityDepartment of Physiology, University of MaiduguriDepartment of Microbiology, Federal University of TechnologyAbstract Background Frequent outbreak of diphtheria occurs in Nigeria and some developing nations due to poverty, poor environmental sanitation, and vaccination coverage. Aim To determine the clinical presentation and outcome of diphtheria in cases admitted in a Yobe Specialist Hospital Potiskum, Yobe State, North-East Nigeria. Methods This is an observational study involving consecutive cases of diphtheria admitted in diphtheria treatment unit (DTU) in the hospital. Cases were admitted from 27th May to 30th October 2023. Results A total of 640 patients were admitted with median age of 9 (1–62), with males constituting 350 (54.6%). Only 9 (1)% of patients had vaccination. Common clinical features included pseudomembrane (90.7%), fever (79.7%), neck pain (78.3%), gross cervical lymphadenopathy (GCL; 69.1%), and sore throat (44.2%). The case fatality rate was 7%, higher in < 5 years (8.4%) than 5–14 years (7.4%) and ≥ 15 years (2.2%) respectively. Independent risk for fatality included delay in presentation (adjusted odd ratio (AOR) = 1.21, 95% confidence interval (CI) [1.10, 1.42], p < 0.001), vomiting (AOR = 3.6, 95% CI [1.36, 9.6], p = 0.01), bleeding from orifices (AOR = 3.76, 95% CI [5.76, 6.98], p < 0.001), blood transfusion (AOR = 8.12, 95% CI [3.34, 19.74], p < 0.001), and diphtheria antitoxin (DAT) administration (AOR = 3.17, 95% CI [1.37, 7.25], p = 0.07). Conclusion Clinical presentation was consistent with diphtheria. Risk of fatality included vomiting, bleeding from orifices, anemia necessitating blood transfusion, delay in presentation, and DAT administration.https://doi.org/10.1186/s43162-024-00372-yDiphtheriaClinical presentationOutcomeNorth-East Nigeria
spellingShingle Ballah Akawu Denue
Rakiya Mohammed Ngoshe
Habu Abdul
Cecilia Balla Akawu
Mohammad Lawan Gana
Anas Yusuf Hussaini
Ajayi Babajide Bamidele
Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
The Egyptian Journal of Internal Medicine
Diphtheria
Clinical presentation
Outcome
North-East Nigeria
title Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
title_full Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
title_fullStr Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
title_full_unstemmed Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
title_short Clinical presentation and outcome of diphtheria in health facility in North-East Nigeria
title_sort clinical presentation and outcome of diphtheria in health facility in north east nigeria
topic Diphtheria
Clinical presentation
Outcome
North-East Nigeria
url https://doi.org/10.1186/s43162-024-00372-y
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