JMIR Publications

ABSTRACT

Background:

Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis

Objective:

This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate.

Methods:

Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case

Results:

Result: A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which are Raymah, Abyan , Sa'ada, Lahj, Al Jawf.

Conclusions:

Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.