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An Observational Study on Association of Clinical Outcome of Diphtheria Cases with Immunization Status: A Tertiary
Shraddha Sharma1, Saket Jammar1, Tanmaya Kataria1
1Department of Otorhinolaryngology, SMS Medical College, Jaipur, Rajasthan India.
Background:
Diphtheria is an important vaccine preventable disease with varied outcome from mild to death. It was observed that the outcome also gets affected with status of immunization. The outcome is relatively milder in immunized children.
Objective:
To find out the clinical presentation and outcome of diphtheria cases and its association with the immunization status.
Methods:
A descriptive analysis of 64 diphtheria cases admitted from January 2019 to May 2020 at SMS hospital, a tertiary care referral hospital in Jaipur.
Results:
Half of (51.56%, 33/60) patients were in the age group of 6-10 years. The peak load (48.44%) of diphtheria cases was seen in the monsoon season. Around 60% of the patients were fully immunized and around 10% partially immunized, every third case was un-immunized. The most common complication was neurological in 13 cases (20.31%), followed by cardiac complications in 11 cases (17.19%), and respiratory (7.81%). The proportion of complication was much lower (26.3%) in immunized cases as compare to partially immunized and un immunized. The proportion of myocarditis was significantly higher in un immunized cases (40%) than partially immunized (16.7%) and filly immunized group (5.3%). Similarly, Bronchopneumonia was also significantly higher (20%) in unimmunized.
Conclusion:
Our study depicted that there has been a shift of age above 5 years for diphtheria which suggests the need for the booster dose. Also high chances of complications are seen in unimmunized and partially immunized calling for public awareness regarding complete immunization.
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