Diphtheria Outbreak Research Articles

Community-led diphtheria vaccination campaign to manage a diphtheria outbreak in a remote Aboriginal community.

In 2022, five cases of diphtheria were identified in and around Wujal Wujal, a discrete Aboriginal community in Far North Queensland. This prompted a mass diphtheria vaccination campaign in the community which increased the proportion of residents aged ≥ 14 years receiving a diphtheria containing vaccine in the prior twelve months from 5% to 74%. No further cases were detected in the subsequent twenty-two months.

Risk factors of diphtheria outbreak in damt district of Al Dhalea Governorate, 2023 -Yemen: a case–control study

BackgroundIn Yemen, diphtheria has become an important health problem since 2017 when diphtheria re-emergence as a consequence of war and the collapse of the health system. In 2023, there has been a 57% increase in diphtheria cases compared to 2021 and 2022. Damt district of Al Dhalea Governorate had the highest reported cases for year 2023. The study aims to determine the risk factors associated with diphtheria outbreak in Damt District.MethodsA retrospective matched case–control (1:2) was used. All confirmed cases based on the WHO case definition reported from Damt district during 2023 were considered cases. Two age-matched (± 5years) neighborhood controls were recruited per case. A pretested questionnaire was used for collecting data during household interviews including demographic and household characteristics, knowledge of diphtheria, vaccination status, contact with a case of diphtheria, and travel history. Frequency and proportion for quantitative and median with interquartile range (IQR) for quantitative variables. Chi-square and Mann–Whitney tests to compare the distribution of categorical and numerical variables between cases and controls. Univariate and multivariate conditional binary logistic regression, and Adjusted Odds ratio (AOR) with a 95% confidence interval at P < 0.05 were used to identify risk factors.ResultsA total of 118 cases and 236 controls were enrolled, 56% were females (63% of cases vs. 53% of controls). The median (IQR) age was 14 (9,22) years for cases vs 12(7,23) of control, it was significantly higher for females than males in the case group: (16(10,29) Vs 10(6,18), P < 0.001) and control group: (15(8,25) vs 12(7,18), p-value = 0.022). Partial vaccination status AOR = 13.7(6.1–31.1), P-value < 0.001), contacts with a case of diphtheria AOR = 8.5(2.3–31.0), P value < 0.001) and Female gender, AOR = 3.3(CI; 1.1–9.5, P value = 0.029), were the main risk factors.ConclusionsPoor vaccination and contact with a case of diphtheria were the main contributors to diphtheria in the Damt district particularly among adult females. Increasing the vaccination coverage with a diphtheria-containing vaccine through routine immunization as well as tetanus-diphtheria vaccine for childbearing age females along with community awareness regarding protection measures during home care of diphtheria cases. Vaccination services as well as gender barriers related to Td vaccination should be investigated.

The Battle against Diphtheria: Nigeria's Ongoing Struggle

Abstract:: Corynebacterium diphtheriae is a Gram-positive, rod-shaped, nonmotile bacillus. Lysogenic strains carry the diphtheria toxin gene (tox) on corynebacteriophages. It's categorized into biotypes and lysotypes based on colony morphology and phage sensitivity. The disease involves the upper respiratory tract, causing symptoms like fever and painful throat, with severe cases forming airway-blocking pseudomembranes [1-3]. Different types of diphtheria exist; incomplete immunization and poor healthcare facilities increase the risk. Diphtheria is treated with diphtheria antitoxin administered intravenously or intramuscularly, along with antibiotics. Timely treatment improves outcomes and reduces transmission. Lifetime immunity is achieved through a three-dose primary series during infancy and booster shots during childhood and adolescence [4]. : Since epidemiological week 26, concluding on July 2, 2023, Nigeria has witnessed a significant surge in diphtheria cases spanning multiple states. Between June 30 and August 31, 2023, 5,898 suspected cases were documented across 59 Local Government Areas (LGAs) in 11 states. In week 34, ending on August 27, 2023, 234 suspected cases were reported from 20 LGAs in five states, with one laboratory-confirmed case out of 22 samples collected. Among these cases, 18 were linked through epidemiological analysis, and 141 were categorized as clinically compatible [5]. Diphtheria incidence has decreased due to widespread DTaP vaccination in children, but declining childhood immunity necessitates booster shots. Recent outbreaks in some nations emphasize the need to maintain high vaccination rates. In Nigeria, a 2022 outbreak resulted in over 600 tragic deaths and around 14,000 suspected cases, a stark contrast to the 2011 outbreak with only 98 reported cases [6]. : In response to the ongoing diphtheria outbreak in Nigeria, the country has implemented several strategies and precautions to combat the disease. Here are the key measures being taken

Deterministic modelling of asymptomatic spread and disease stage progression in vaccine preventable infectious diseases

AbstractThis study introduces a deterministic formulation for modelling the asymptotic spread of a vaccine preventable disease as well as the different stages for the progression of the disease. We derive the formula for the associated basic reproduction number. To illustrate the proposed model, we use data from the 2017–2018 diphtheria outbreak in Yemen and fit the parameters of the model. A sensitivity analysis of the basic reproduction number, with respect to the model parameters, show that this number increases with an increase of the transmission rate while this number decreases when vaccination rate increases.

Factors Associated with the Outcome of 2023 Diphtheria Outbreak in Jigawa State, Nigeria: A Retrospective Review of the Surveillance Data.

The objective of this study was to identify the factors associated with the outcome of the 2023 diphtheria outbreak in Jigawa State, Nigeria. A descriptive cross-sectional study was conducted amongst all line-listed diphtheria cases reported from Jigawa State, Nigeria, using the 2023 Integrated Disease and Surveillance Response line list of cases that met the World Health Organization case definition of diphtheria. A total of 245 line-listed cases from January 2023 to December 2023 met the criteria for inclusion in the study. Data were analysed using IBM SPSS version 22.0 with a P value set at ≤5%. Binary logistic regression was used to identify the independent predictors of the outcome of the 2023 outbreak. The maximum age of the line-listed cases was 39 years, and the minimum was 1 year with a median of 8 (interquartile range = 5-8) years. More than two-thirds (68.2%) of the cases were ≥5 years of age. More than one-third of the cases (39.6%) were from the northeast senatorial zone of the state. Out of the total 245 cases, 14 died of the disease representing a case fatality rate of 6%, and an attack rate of 3.4 per 100,000 populations. The majority of the cases (95.5%) had fever, cough (81.2%), pharyngitis (86.9%), tonsillitis (96.7%) and laryngitis (82.0%). More diphtheria-related mortalities were recorded amongst cases <5 years of age (7.7%), female cases (5.9%), rural residence (7.7%) and cases from the northeast senatorial zone (8.2%) of the state. Significantly higher mortalities (8.8%, P = 0.003) were recorded amongst cases with nasopharyngitis. The odds of diphtheria-related mortality were higher amongst cases who presented clinically with nasopharyngitis and were 4 times more likely to die (adjusted odds ratio = 3.9; 95% confidence interval = 1.1-14.3) compared with those with no nasopharyngitis. Significantly higher mortalities were recorded amongst diphtheria cases whose samples were not taken, and those with nasopharyngitis. These findings underscored the importance of improved immunisation uptake, early and prompt case detection, investigation and proper management.

Spatial Analysis of Response Initiative to the outbreak of Diphtheria in Ojo Local Government Area of Lagos State, Nigeria.

In the Africa Continent, diphtheria remains a pressing public health concern. Despite advancements in healthcare infrastructure and vaccination efforts, several countries continue to report cases and outbreaks, indicating ongoing transmission of the disease. This research aimed at utilizing GIS application in diphtheria outbreak in the Ojo Local Government Area (LGA) of Lagos State, Nigeria, with the following objectives: (i) obtain the spatial distribution pattern of the spread of diphtheria outbreak. (ii) determine the area requiring immediate attention and response in the study area. (iii) showcase areas that are vulnerable within the study area. In the pursuance of this both primary data, including geographical coordinates of confirmed diphtheria cases, and secondary data such as recorded cases, population density, vaccination coverage, and transportation networks, the research utilizes ArcGIS for visualization and analysis, Differential Global Positioning System (DGPS) receivers ensured accurate spatial data collection, supplemented by ground truthing of secondary data. The result revealed significant clusters of diphtheria cases in Akesan-Obadore and Ijegun, indicating a higher concentration of infections. The study applied average nearest neighbor analysis, which indicated a dispersed pattern of outbreaks within the LGA. Furthermore, a risk assessment using Analytic Hierarchical Process (AHP), in identifying the southern parts and Iba ward of Ojo LGA as areas with highest risk. The study recommends to the Lagos State Government to enhance vaccination efforts and improve sanitation infrastructure in these high-risk areas to mitigate the spread of diphtheria.

Diphtheria in a Swiss Asylum Seeker Reception Centre: Outbreak Investigation and Evaluation of Testing and Vaccination Strategies.

Objectives: To describe a suspected diphtheria outbreak in a Swiss asylum seeker reception centre, and to analyse its management response regarding testing and vaccination. Methods: We retrospectively analysed clinical, microbiology, and case management data of all asylum seekers tested for C. diphtheriae between 28th August and 31st December 2022 while residing at the centre. Results are reported descriptively. Results: Among 265 individuals tested, ten cases of cutaneous diphtheria, one simultaneous respiratory and cutaneous case, and nine respiratory carriers were identified. Mass throat screening, targeted throat testing and targeted wound testing yielded 4.8%, 4.3%, and 17.4% positive results, respectively. No respiratory carrier was identified among cutaneous cases undergoing a throat swab, and no symptomatic case was identified among individuals with unspecific throat symptoms. Rates of vaccination implementation of newly arriving asylum seekers before and after the outbreak were low (17.5% and 15.5%, respectively), as were rates of targeted vaccination among cases and close contacts. Conclusion: We provide evidence for transmission both prior to arrival and within the setting, suboptimal practices and timeliness of testing, and implementation gaps in vaccination.

Balto and Togo during the cold winter of Alaska (1925): the two canine heroes in the fight against diphtheria.

In recent years, diphtheria has re-emerged in areas with inadequate vaccination coverage, and Europe has not been spared with several cases among migrants. Diphtheria is a potentially fatal infection caused mainly by toxigenic strains of Corynebacterium diphtheriae. Due to the high mortality rate, especially among young children, the fight against diphtheria is considered one of the first conquests of immunization. In the history of medicine, there is a unique case of an unconventional response to a diphtheria outbreak in which sled dogs were used to overcome the supply difficulties of diphtheria antitoxin. The mass media followed the medical response to the outbreak and raised audience awareness of public health issues. The facts of Nome, Alaska, in 1925 can serve as a catalyst to rethink conventional responses to diphtheria outbreaks in low-income countries today and promote mass media awareness of public health importance.

Spatial Spread of Diphtheria and Public Health Engagement in Nigeria

Diphtheria is a potentially fatal and highly contagious vaccine-preventable disease that spreads between people mainly by direct contact or through the air via respiratory droplets. The disease can affect all age groups; however, unimmunized children are particularly at risk. This article examines the spatial spread of diphtheria in Nigeria. The paper examines community awareness and public health actions taken by various actors and stakeholders to alleviate the diphtheria outbreak. The risks of spreading diphtheria and the vulnerability of children due to poor immunisation are frightening. Consistency in data collection and good quality (quantitative) data provides a basis for timely intervention and future response to the treatment of diphtheria. Curtailing crowding, reducing multidimensional poverty and social inequalities, and enhancing hygienic practices (WASH) are practical measures to reduce spread, infection, and death arising from the diphtheria outbreak in Nigeria and other countries.

Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen

Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes.&#x0D; Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen.&#x0D; Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis.&#x0D; Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P&lt; 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%.&#x0D; Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.

Sociological interventions for the diphtheria outbreak in Nigeria: addressing misconceptions, cultural biases, and promoting vaccination

Diphtheria is a fatal bacterial infection primarily affecting the respiratory system, characterized by a thick membrane formation in the throat, caused by Corynebacterium diphtheriae. This manuscript elucidates sociological interventions, aimed at protecting the population of Nigeria from diphtheria, a preventable yet persisting health threat. It delves into diverse strategies that could be employed to combat misconceptions, navigate deeply ingrained cultural biases, and instill the significance of vaccination within the context of diphtheria outbreak and prevention. The research question was: "What are the sociological interventions, used to address misconceptions, cultural biases, and promote vaccination in the context of diphtheria prevention in Nigeria?" In response to this inquiry, a comprehensive review methodology was employed to systematically gather, evaluate, and synthesize relevant literature outputs. The literature search, conducted across diverse academic databases and repositories, yields a rich collection of studies, reports, and case studies. The lens of Symbolic Interactionism was applied. The sociological interventions, considered in this context, engage directly with communities, healthcare providers, and local leaders. It addresses the vital need to combat misconceptions, cultural biases, and vaccine hesitancy, fostering a deeper understanding of the dynamic interplay between sociological factors and healthcare interventions. Sociological interventions for diphtheria protection in Nigeria require culturally sensitive approaches, community engagement, health education, addressing vaccine hesitancy, offering accessible vaccination services, tackling socioeconomic barriers, targeted messaging, behavioral change communication, data collection, and research collaborations to understand and address sociocultural factors influencing vaccine uptake and prevention. The findings and implications offer valuable insights for policymakers, healthcare providers, and researchers, and lay the groundwork for more effective strategies to protect the population from this preventable disease

Assessing the impact of booster vaccination on diphtheria transmission: Mathematical modeling and risk zone mapping

The COVID-19 pandemic caused significant disruptions in the healthcare system, affecting vaccinations and the management of diphtheria cases. As a consequence of these disruptions, numerous countries have experienced a resurgence or an increase in diphtheria cases. West Java province in Indonesia is identified as one of the high-risk areas for diphtheria, experiencing an upward trend in cases from 2021 to 2023. To analyze the situation, we developed an SIR model, which integrated DPT and booster vaccinations to determine the basic reproduction number, an essential parameter for infectious diseases. Through spatial analysis of geo-referenced data, we identified hotspots and explained diffusion in diphtheria case clusters. The calculation of R0 resulted in an R0 = 1.17, indicating the potential for a diphtheria outbreak in West Java. To control the increasing cases, one possible approach is to raise the booster vaccination coverage from the current 64.84% to 75.15%, as suggested by simulation results. Furthermore, the spatial analysis revealed that hot spot clusters were present in the western, central, and southern regions, posing a high risk not only in densely populated areas but also in rural regions. The diffusion pattern of diphtheria clusters displayed an expansion-contagious pattern. Understanding the rising trend of diphtheria cases and their geographic distribution can offer crucial insights for government and health authorities to manage the number of diphtheria cases and make informed decisions regarding the best prevention and intervention strategies.

Vaccine hesitancy under the lens: Nigeria's struggle against the worst diphtheria outbreak in decades.

The resurgence of diphtheria in Nigeria, culminating in an outbreak surpassing previous records, has spotlighted the critical imperative for robust immunization policies amidst a milieu of vaccine hesitancy. This commentary delineates the multifaceted dimensions of the current diphtheria outbreak, which started in May 2022, juxtaposed against historical outbreaks, with a focal examination of the pervasive vaccine hesitancy and its underpinning sociocultural and systemic determinants. The discourse extends to a meticulous evaluation of Nigeria's public health response, underlined by the synergy with international organizations, reflecting a global collaborative ethos in combating the diphtheria menace. A critical appraisal of the prevailing immunization policies unveils a necessity for strategic amendments to invigorate vaccination uptake, essential for curbing the diphtheria outbreak and enhancing public health resilience. The reflections herein advocate for a comprehensive, culturally resonant, and sustainable public health paradigm, encompassing a synergistic approach of policy fortification, community engagement, and international collaboration to navigate the challenges posed by vaccine-preventable diseases epitomized by the ongoing diphtheria outbreak. Through a synthesis of historical lessons, contemporary challenges, and global solidarity, this piece contributes to the broader discourse on enhancing immunization coverage and infectious disease control in Nigeria.

Lessons from a school-based vaccination response following a Diphtheria outbreak in eThekwini district, SA.

This study adds to the limited data describing a school-based vaccination in an outbreak response and highlights successes and challenges. School-based outbreak vaccination response can rapidly increase vaccine coverage; however, additional community engagement may be required in vaccine-hesitant populations.

A Cost‐Effective Epidemiological Exposition of Diphtheria Outbreak by the Optimal Control Model: A Case Study of Rohingya Refugee Camp in Bangladesh

A Cost‐Effective Epidemiological Exposition of Diphtheria Outbreak by the Optimal Control Model: A Case Study of Rohingya Refugee Camp in Bangladesh

Epidemiological Investigation of Diphtheria Extraordinary Events (KLB) In Gili Ketapang Village, Probolinggo Regency In 2022

Diphtheria infection is caused by a toxigenic strain of Corynebacterium diphtheriae with humans as the only reservoir. Diphtheria attacks children under 10 years old and is highly contagious, especially in susceptible populations. Diphtheria can cause an outbreak although it can be prevented by immunization. In 2022, 3 cases of diphtheria were reported in Gili Ketapang Village, Probolinggo Regency. Objective: to describe the epidemiology of the outbreak and identify the risk factors for countermeasures. Methods: This research is a descriptive study with an outbreak investigation report design. Results: There were 3 cases of diphtheria within 7 months (February-August 2022) in Gili Ketapang Village with a CFR of 100% and the highest attack rate in the toddler age group (0-4 years) of 0.5%. There were 2 positive contacts (close contacts of 2nd Case) who were asymptomatic. Transmission is strongly suspected to be caused by the carrier. The identified risk factors were low IDL coverage, limited health facilities and availability of ADS, sociodemographic conditions, and population mobility at risk of diphtheria transmission. The problems found were the absence of PMO in providing prophylaxis and ORI coverage was still low and incomplete. Conclusions and suggestions: The diphtheria outbreak in Gili Ketapang Village has been confirmed by the laboratory test. The increase in the incidence and mortality from diphtheria is caused by multi factors. The government's role in increasing immunization coverage, early warning through active case finding surveillance, monitoring, and evaluation of obstacles in prevention is urgently needed.

Understanding the Trend of Diphtheria Outbreak in Nigeria from 1941-2023: A Narrative Review

Diphtheria is a contagious infection caused by Corynebacterium diphtheriae spread through respiratory droplets, typically from coughing or sneezing, and characterized by difficulty in breathing, heart rhythm challenges, and even death. Objective: This narrative review explored the trend of Diphtheria outbreaks in Nigeria and suggested a way to forestall reoccurrence. We search two bibliographic databases, PubMed and Scopus, to identify studies using the keywords “Diphtheria” and “Nigeria”. Approximately eighty-two (82) years after isolating virulent strains of Corynebacterium diphtheriae in Nigeria, the country still suffers recurrent outbreaks of Diphtheria, a vaccine-preventable infection. Between the years 1974 to 2021, the World Health Organization (WHO) documented 40258 reported cases of diphtheria in Nigeria, although it missed 117 cases reported in Lagos, Benin, Katsina, and Borno between 2007 and 2017, where a 21.4% fatality was recorded in Borno alone. The current outbreak, labeled as one of the most severe outbreaks in Nigeria in recent years, so far, has 798 cases and 10% case fatality with the northern part of the country being particularly hard hit. The recurrence of the Diphtheria outbreak in Nigeria is attributed to incomplete vaccination exacerbated by poor vaccination coverage (e.g., &lt; 50% in 2016), waning vaccine-induced immunity, maternal knowledge, and poverty. Incomplete immunization resulting from poor immunization coverage, poor sensitization, and lack of access to healthcare facilities is undoubtedly the single predominant determinant of Diphtheria outbreaks in Nigeria. There is an urgent need to promote complete immunization to prevent resurgence and re-emergence.

Recurrent diphtheria outbreaks in Nigeria: A review of the underlying factors and remedies.

The introduction of the diphtheria-tetanus-pertussis (DTP) vaccine into childhood immunization programs resulted in its widespread elimination in high-income countries. However, Nigeria is currently experiencing an outbreak. The primary cause of diphtheria outbreaks and its high mortality rates in Nigeria was waning herd immunity due to low DTP coverage and a lack of diphtheria antitoxin (DAT), respectively. However, the underlying causes of Nigeria's low DTP coverage and DAT supply remain unknown. Relevant studies and reports included in our review were obtained by a search through Google Scholar, PubMed, and organization websites using the terms "Diphtheria-Pertussis-Tetanus vaccine OR Diphtheria antitoxin and Nigeria OR Diphtheria Outbreak." All articles considering diphtheria outbreaks, DTP vaccine, and DAT supply in Nigeria were considered without time restriction due to the paucity of data. We used the narrative synthesis approach to critically appraise, analyze, and draw inferences from the selected articles. The main causes of low DTP coverage are insufficient supply, an inefficient cold chain system, and low uptake due to poor health literacy and negative sociocultural and religious beliefs, whereas the key barriers to DAT availability are insufficient production by pharmaceutical industries because of low demand and priority. The underlying causes of Nigeria's low DTP coverage and DAT supply are multifactorial. Both short-term and long-term measures are needed to control this outbreak and prevent future occurrences.

Genomic characterization of cocirculating Corynebacterium diphtheriae and non-diphtheritic Corynebacterium species among forcibly displaced Myanmar nationals, 2017-2019.

Respiratory diphtheria is a serious infection caused by toxigenic Corynebacterium diphtheriae, and disease transmission mainly occurs through respiratory droplets. Between 2017 and 2019, a large diphtheria outbreak among forcibly displaced Myanmar nationals densely settled in Bangladesh was investigated. Here we utilized whole-genome sequencing (WGS) to characterize recovered isolates of C. diphtheriae and two co-circulating non-diphtheritic Corynebacterium (NDC) species - C. pseudodiphtheriticum and C. propinquum. C. diphtheriae isolates recovered from all 53 positive cases in this study were identified as toxigenic biovar mitis, exhibiting intermediate resistance to penicillin, and formed four phylogenetic clusters circulating among multiple refugee camps. Additional sequenced isolates collected from two patients showed co-colonization with non-toxigenic C. diphtheriae biovar gravis, one of which exhibited decreased susceptibility to the first-line antibiotics and harboured a novel 23-kb multidrug resistance plasmid. Results of phylogenetic reconstruction and virulence-related gene contents of the recovered NDC isolates indicated they were likely commensal organisms, though 80.4 %(45/56) were not susceptible to erythromycin, and most showed high minimum inhibition concentrations against azithromycin. These results demonstrate the high resolution with which WGS can aid molecular investigation of diphtheria outbreaks, through the quantification of bacterial genetic relatedness, as well as the detection of virulence factors and antibiotic resistance markers among case isolates.

Diphtheria Outbreak among Children in 2017–2018: a Single Centre Study in Indonesia

Diphtheria is an acute infectious disease caused by the bacterium Corynebacterium diphtheria. Accurate and prompt diagnosis is essential for effective case management, predicting disease prognosis, preventing complications, and ensuring cost-effective medical intervention. This study aimed to assess the variety of clinical symptoms exhibited by pediatric diphtheria cases during an outbreak. An observational cross-sectional study was conducted using data from the medical records of pediatric diphtheria cases at Sulianti Saroso Infectious Disease Hospital from November 1, 2017, to February 28, 2018. The study involved 202 cases, and statistical analysis was performed using the chi-square test. Out of the 202 cases, 58.4% were male. Age distribution was &lt;1 year: 7.4%, 1–2 years: 3.5%, &gt;2–5 years: 24.8%, &gt;5–12 years: 45.5%, and &gt;12 years: 18.8%. Anamnestic findings revealed the presence of fever in 88.1% of patients, pain upon swallowing in 73.3%, and cough in 55.4%. Clinically, every patient exhibited pseudomembrane formations. Other findings included bilateral tonsillar involvement in 53%, lymphadenopathy in 40.1%, bullneck in 17.8%, and snoring in 7.9%. Four significant variables were associated with the diphtheria diagnosis: fever, snoring, bullneck, and snoring (p&lt;0.05) respectively. Clinical signs and symptoms are pivotal in establishing a diphtheria diagnosis in pediatric cases.