Diphtheria Patients Research Articles

Eleven-Year Report of High Number of Diphtheria Cases in Children in East Java Province, Indonesia.

A high incidence of diphtheria cases in children in East Java province, Indonesia, has been observed since the beginning of this century. Despite many efforts, the outbreaks continue. This study aims to explain the high incidence of diphtheria in children in East Java province since 2013. This cross-sectional surveillance report-based study used data from 38 districts in East Java since 1 January 2013. Collected data included demographics, clinical information, additional examinations, immunization history, and close contact management. Over eleven years, there were 4009 diphtheria patients, of whom 2921 (72.86%) were under 18 years of age. Boys (59.77%) outnumbered girls, and the most common age category was >60-144 months (51.66%). Most cases had incomplete or zero immunization (76.16%). Tonsillopharyngeal diphtheria was the most common type (69.60%). The five top districts with the most cases were Surabaya, Sidoarjo, Kabupaten Blitar, Kota Malang, and Kabupaten Malang. The eleven-year case fatality rate (CFR) was 2.36% (69/2921). This study shows that diphtheria cases in children and adolescents in East Java have consistently been high, and low immunization coverage might still be the leading cause. There has also been a shift in the district distribution. Diphtheria outbreaks require complete and sustainable efforts, not just outbreak response immunizations.

Profiles of diphtheria cases in children in Hasan Sadikin Hospital, West Java

Background Diphtheria cases continue to be reported in Indonesia, which has long been one of the countries with the highest number of diphtheria cases worldwide. One of Indonesia's province with the highest annual diphtheria cases is West Java. Dr. Hasan Sadikin General Hospital (RSHS) is one of the tertiary referral hospitals in Bandung, West Java, that treats several diphtheria cases annually. No study focused on the clinical characteristics of diphtheria cases in children admitted to RSHS between 2017 and 2021 yet. Therefore, this study sought to analyze that. Objective To find out the profiles of children < 18-year-old with diphtheria admitted in RSHS between 2017-2021. Methods This descriptive, cross-sectional study reviewed the medical records of diphtheria patients 0 to 18-year-old who were admitted to RSHS between year 2017 and 2021. Results Out of 45 subjects, 76% were males. The median of age was eight years old, ranging from 2 to 17 years. Most patients lived in urban areas and had normal anthropometry status, although some showed abnormal findings. The data showed that 44% had more than 3 days of onset until admission to the hospital, and the median length of stay was 9 days. The clinical characteristics showed that 91% of patients had pseudomembrane, also present with cough, common cold, hoarseness, stridor, and bull’s neck. As many as 44% of patients did not have complete basic immunization status. Complications found were airway obstructions, myocarditis, and sepsis, and 2 deaths were reported. Conclusion Pseudomembrane was found in the majority of patients. Most patients were over five years of age, and almost half number of the patients did not have complete basic immunization status, indicating the need for improved immunization and booster coverage.

Determinants of mortality in relationship between clinical and laboratory characteristics with the outcomes of children with diphtheria: A cross-sectional study at a national hospital of Sumatra region in 2020- 2023.

In 2017, diphtheria outbreaks occurred in several provinces in Indonesia; however, the epidemiological data in the country is limited. The aim of this study was to determine the association between clinical findings and laboratory parameters associated with mortality of children with diphtheria. A retrospective cohort study was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, covering diphtheria patients from January 2020 to December 2023. All patients aged 1-18 years clinically diagnosed with diphtheria were considered eligible. The associations between demographic characteristics, clinical features, immunization status, complications, and laboratory profiles with mortality were determined using Fisher's exact test, and the odds ratio (OR) with a 95% confidence interval (95%CI) was calculated. Our data indicated that the clinical characteristics of myocarditis (p=0.005) and airway obstruction (p=0.003) were associated with mortality. There was also a significant association between thrombocytopenia (p=0.020) and mortality in diphtheria patients. Patients with airway obstruction were 13 times more likely to have an increase in mortality compared to patients without airway obstruction. This study highlights that clinical and laboratory characteristics could be associated with in-hospital mortality of diphtheria cases, and therefore, pediatricians should be aware of the presence of those characteristics to prevent the mortality of the patients.

Clinical And Laboratory Characteristics of Diphtheria Patients Treated at RSUP Haji Adam Malik in 2020 - 2023

Clinical And Laboratory Characteristics of Diphtheria Patients Treated at RSUP Haji Adam Malik in 2020 - 2023

Post-diphtheritic Polyneuropathy in Children with Diphtheria: A Prospective Observational Study

This study aimed to determine the proportion of diphtheria patients who develop post-diphtheritic polyneuropathy (DP) later on and also to study the clinical features and outcomes of children with post-DP. This prospective observational study was conducted at the Department of Pediatrics, King George’s Medical University, Lucknow, Uttar Pradesh, India. Children under 14 hospitalized with clinically diagnosed diphtheria and post-DP were recruited (n = 81). Detailed clinical examination with appropriate investigations was conducted, including throat swabs for staining and culture for Corynebacterium diphtheria, nerve conduction studies, electrocardiography, and echocardiography. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 16.0. Seventy-four cases of diphtheria and seven cases of post-DP were enrolled, 56.8% were male, and the most prevalent age group afflicted was two to five years. Fifty-three children (65.4%) were partially immunized for diphtheria. Neck swelling, voice change, difficulty breathing, noisy breathing, respiratory involvement, and stridor were significantly more common in the unimmunized group. Voice change, heart rate irregularity, and hypotension were substantially more common in patients who developed clinical neuropathy than those who did not. Early administration of antibiotics in children with diphtheria before hospital admission was found to be significant in those children who did not develop clinical polyneuropathy, 38.5% of diphtheria survivors had abnormal nerve conduction study at six weeks of illness. Neck swelling and change in voice were significantly more common in patients with abnormal nerve conduction velocity (NCV) than in normal nerve conduction studies, 87.5% of children who had taken antibiotics before hospital admission had no clinical neuropathy, and NCV was also normal. Clinical neuropathy developed in just 20% of diphtheria patients with impaired NCV. Any child diagnosed with diphtheria should be followed for three to six months in anticipation of neurological complications. DP carries a good prognosis; hence, timely diagnosis and differentiation from other neuropathies is a prerequisite for rational management.

Clinical Manifestation of Childhood Diphtheria

Even though diphtheria vaccination has been routinely done all around the world, some of developing country still reported outbreak. Indonesia declared diphtheria outbreak in 2017. Diphtheria is characterized by sore throat, fever and the formation of pseudo-membrane located in the tonsils, pharynx or nasal cavity. Diphtheria is very common in children. This study was conducted to determine the clinical picture of diphtheria in children at Sulianto Saroso Infectious Disease Hospital January 2018 - December 2018. The study was descriptive cross – sectional using medical records of diphtheria patients for the period January 2018 – December 2018. The sample is 141 diphtheria patients with the total sampling method. Data analysis using univariate. In this study, out of 141 children with diptheria, the highest number of cases was recorded boy (58,2%), among 6-11 years old, and fully vaccinated (60.3%). Most patient complained about sore throat (95%), fever (93.6%), and bullneck (32.6%). Majority of diphtheria patients with bilateral tonsillar membranes were also found (71.6%), followed by the majority of negative culture results (66.7%), experienced no complications (78.7%), and discharge (99.3%). Clinical characteristic that commonly appeared were sore throat, fever, and bilateral tonsillar membrane. We found it is important to diagnose and treat early to prevent complication and mortality.

A Study on the Characteristics and Outcomes of Reported Diphtheria Patients in a Western State in India.

Background The incidence of diphtheria cases has declined significantly from 1,00,000 cases in 1980 to 2500 in 2015 globally. India contributed to half of the diphtheria cases reported globally from 2001 to 2015. The disease has higher case mortality and morbidity rate due to various geographic-specific factors. The current study aims to outline the characteristics and outcomes of the diphtheria-reported patients of Gujarat, a western state of India. Method A record-based, descriptive retrospective study was undertaken in the western state of India by analyzing district-wise reported diphtheria cases in diphtheria, tetanus, and pertussis (DPT) surveillance program format during 2020-2021. Result Out of 446, most patients were reported from selected geographies of Gujarat state in 2020-2021. The 424 (95%) reported cases were from 0-14 years of age. Only 9 (2%) subjects had a travel history, and 369 (82.7%) patients were reported from rural areas. The time trend analysis showed that 339 (76%) patients were reported from September to December. The case-fatality ratio was 5.4%, and 300 (67.2%) cases didn't take the DPT (DPT3)/pentavalent 3rd dose vaccine and subsequent doses during their lifetime, emphasizing the role of the vaccine in preventing diphtheria disease. Conclusion Increased vaccination coverage and completing all doses of the DPT vaccine are crucial to avert deaths due to diphtheria. An effective surveillance system will aid in early disease detection and provide more information on the factors that lead to disease occurrence for prompt action by the authority.

Da li je difterija zaboravljena bolest?

Diphtheria is a severe infectious disease that can be prevented by vaccination. In the past few decades, it has re-emerged in connection with reduced vaccination coverage in the countries affected by war or social unrest. During the past decade, the migrant crisis additionally influenced the reappearance of diphtheria, especially its cutaneous forms. On the other hand, in many countries, diphtheria is considered an eliminated infection, and over time attention paid to this disease has decreased, as has the level of knowledge about laboratory and clinical diagnostic methods. Suspicion of the cutaneous or respiratory forms of diphtheria potentially present in migrants who pass the so-called Balkan route initiated the establishment of an active surveillance system to be considered with the aim of early detection of potential cases, adequate sampling, laboratory testing, treatment and implementation of relevant measures regarding exposed contacts. The aim of this review article was to raise the level of awareness of physicians who may come into contact with diphtheria patients, as well as to revise the knowledge required for adequate laboratory confirmation of the diagnosis and supervision. The paper presents an overview of the current literature in this field, as well as recommendations for laboratory work and supervision.

Analysis of Diphtery Disease Mortality In Indonesia Using Zero Inflated Conway Maxwell Poisson Regression Model

Diphtheria is an upper respiratory tract disease caused by the bacteria Corynebacterium Diphtheriae. Diphtheria is a dangerous infectious disease, because there were 23 deaths from 529 cases in 2019. The data used in this final project research is secondary data taken from the Health Office in 2019. The number of deaths of diphtheria patients is calculated data and the assumption is distributed as a Poisson distribution. . The number of zero data of 73.5 percent indicates an overdispersion of the response variables. One of the conditions of Poisson Regression is that it requires equality between the mean and variance, this model is not appropriate to be applied to the dispersion below and above. The Zero Inflated Conway Maxwel Poisson (ZICMP) regression model can be an alternative because it is flexible for under- and over-dispersion data and can solve the problem of excess zero values in the response variable. In this study, ZICMP was applied to mortality cases in diphtheria patients in Indonesia. This study aims to examine the probability function and develop an algorithm to estimate ZICMP parameters and apply the ZICMP model to mortality cases in diphtheria patients. The Maximum Likelihood Estimation (MLE) method is used to estimate the parameters in ZICMP and the probability function is maximized using the Expectation-Maximization (EM) algorithm.

A clinical profile of severe diphtheria in pediatric intensive care units of North India

Background: Myocarditis, disseminated intravascular coagulation, and renal failure have been reported to be the leading causes of mortality in patients of severe diphtheria. The aim of this article was to study the clinico-demographic profile of diphtheria patients and also to evaluate the performance of Pediatric Risk of Mortality (PRISM) III on the prediction of mortality in such patients. The objective was to study the clinical profile of severe diphtheria cases in children. Subjects and Methods: During the study period, 170 patients were admitted to the pediatric emergency unit, out of whom 26 patients were admitted with the diagnosis of clinical diphtheria. Results: Majority of the patients were categorized as having either central nervous system or respiratory illness at the time of admission. The third largest category was patients with suspected clinical diphtheria. Forty-five out of 170 were nonsurvivors among which the highest mortality was noted in patients of diphtheria. All the nonsurvivors with clinical diphtheria had signs and symptoms of myocarditis either at the time of admission or developed later during the hospital stay. On comparing the mean PRISM scores of survivors versus nonsurvivors, it was not found to be statistically significant. Conclusions: The presence of myocarditis in patients of diphtheria is highly fatal and PRISM III alone is not sufficient for mortality prediction in patients of severe diphtheria.

Clinical and Laboratory Profile of Diphtheria Patients and Role of Diphtheria Antitoxin in Recent Outbreak of Diphtheria in Bageshwar District of Uttarakhand: A Case Series

Clinical and Laboratory Profile of Diphtheria Patients and Role of Diphtheria Antitoxin in Recent Outbreak of Diphtheria in Bageshwar District of Uttarakhand: A Case Series

Spectrum of Neurological Outcomes in Diphtheria: A Case Series.

Diphtheria is an acute infectious disease caused by the exotoxin produced by Corynebacterium diphtheriae, a gram positive bacteria. It has propensity to affect mainly cardiac muscle and nervous system. To study the percentage, spectrum of patients with various neurological complications and the pattern of recovery in followed up confirmed cases of diphtheria. Single centre prospective analysis of neurological complications in diphtheria patients from June 2019 to September 2020 at SMS Medical College and hospital,Jaipur. In this study, 60 cases were included. Immunised cases were 60% (36 out of 60 cases) whereas unimmunised constituted the rest 40% (24 out of 60 cases). Neurological complications were observed in 15% of the cases (9 out of 60). Isolated palatal palsy was the most common complication (4 out of 9 cases, 44.44%), succeeded by lower limb LMN palsies (2 out of 9 cases, 22.22%) with unilateral facial nerve palsy, bilateral abductor palsy and paralytic ileus constituting the rest (1 out of 9 cases each, 11.11% each). Onset of complications ranged from 10 to 36days whereas recovery was complete and without any residual sequelae between 60 to 240days. Our study concluded that neurological complications form a sizeable portion of post diptheritic complications and carries good prognosis, hence timely diagnosis and differentiation from other neuropathies is a pre requisite for rational management and contact tracing.

Trend, morbidity profile and immunization status of diphtheria admitted cases: A 5-years review from a sentinel centre in Kolkata.

Despite strengthening of the universal immunization program, diphtheria remains endemic in India. Diphtheria is under surveillance for vaccine-preventable diseases of the World Health Organization and also in India. The present record-based retrospective study was conducted on 241 confirmed diphtheria patients admitted in an infectious disease hospital of Kolkata over 5 years (2015-2019) with the objectives of assessing the admission trend, immunization status, and outcome of patients. Among the patients, majority (57.3%) were female; 50.6% were ≥15 years; 49.0% resided in rural areas. Five-year admission rate did not show any declining trend. Major number of cases occurred in 2016; another peak observed in 2019. Only 27.4% fully immunized rest either partiality immunized (44.4%) or nonimmunized (28.2%). Overall, 54% of the patients developed any complications, and case fatality was 9.5%. Gradual age shift toward adults reiterated the widespread use of adult immunization with Td vaccines. Early reporting to the hospital is necessary to reduce complications and case fatality.

Detection of toxin-producing Corynebacterium diphtheriae from throat swabs of diphtheria patients using duplex real-time PCR.

Background and Objectives:Diphtheria is a potentially fatal disease caused by toxigenic bacterial infection, particularly from Corynebacterium diphtheriae (C. diphtheriae). Isolation of C. diphtheriae is technically lacking in sensitivity, and Elek’s test to detect toxin production has several difficulties associated with its application. Duplex real-time PCR to throat swab of suspected diphtheria patients can detect both bacteria and toxin-encoding genes simultaneously, faster, with higher sensitivity and specificity.Materials and Methods:A total of 89 consecutive throat swabs from suspected diphtheria patients were collected from Sulianti Saroso Infectious Disease Hospital, Jakarta, during 2018 to 2019. Two pairs of primers and probes, targeting the rpoB gene of C. diphtheriae and the A-subunit of the diphtheria toxin gene, were used in this study. Parameters including annealing temperature, concentration of primers and probes, inhibitors, cross-reaction and detection limit were all optimized. Elek’s toxigenicity test and clinical data were analyzed for comparison.Results:The optimum annealing temperature was 55°C. The concentrations of Cd primer, Tox primer, Cd probe and Tox probe were 0.4, 0.6, 0.5 and 0.625 µM, respectively. DNA elution and template volumes were 50 µL and 5 µL. The detection limit was 2 CFU/mL. No cross-reaction with other microorganisms was observed. Of the 89 samples, duplex real-time PCR gave better results than the standard test, with 19 (21.3%) and 10 (11.2%) patients diagnosed with diphtheria, respectively.Conclusion:Duplex real-time PCR increases the rate of laboratory diagnosis of diphtheria, compared to the standard method to detect potentially toxigenic C. diphtheriae.

Characterization of toxigenic Corynebacterium diphtheriae strains isolated in Russia

The aim of the study was to characterize toxigenic strains of Corynebacterium diphtheriae by examining 12 toxigenic strains of C. diphtheriae isolated in Russia between January, 2017 to June, 2019. The morphological, toxigenic and biochemical properties of C. diphtheriae was studied. Genotyping of C. diphtheriae strains was performed using MLST and dtxR gene sequencing with subsequent phylogenetic analysis. Results. Toxigenic strains of C. diphtheriae were isolated in the Novosibirsk, Samara and Chelyabinsk Regions, the Khanty-Mansi Autonomous Okrug — Yugra as well as the Republic of Northern Ossetia — Alania. Among these strains, 5 were isolated from diphtheria patients (moderate disease found in one case, mild course — remaining patients) and 7 strains were isolated from bacterial carriers. In two cases C. diphtheriae from diphtheria patients were identified as ST25 sequence type, gravis variant; in one case — ST8 type, gravis variant; two cases — ST67 sequence type, mitis variant. In asymptomatic carriers of tox-positive C. diphtheriae strains they belonged to ST25 sequence type, gravis variant — in two cases, ST67 type, mitis variant — in four cases. A sequencing type was not identified in one case. All sequence types were widespread globally being presented by a large number of isolates in the PubMLST and characterized by a substantial amount of derivative sequence types. At the same time, they belonged to different clonal complexes and differed markedly from each other contributing to their reliable difference as assessed by MLST. Study of gene dtxR sequence diversity showed that all allelic variants were typical for the representatives of these sequence types. New alleles of gene dtxR were not revealed in strains examined. It was shown that non-synonymous substitution C440T leading to A147V amino acid substitution was found solely in one allele distributed in ST8, ST185, ST195 and ST451 types suggesting at late mutation. In contrast, the polymorphism C640A resulting in the amino acid substitution L214I was found not only in the same allele, but also in the basal tree branches indicating that isoleucine was in the ancestral sequence of the protein.

Diphtheria in Metro Manila, the Philippines 2006-2017: A Clinical, Molecular, and Spatial Characterization.

BackgroundDiphtheria is a vaccine-preventable disease that persists as a global health problem. An understanding of the pattern of disease is lacking in low- and middle-income countries such as the Philippines.MethodsWe conducted a retrospective review of the clinical, microbiological, and epidemiological features of patients admitted with a clinical diagnosis of diphtheria to an infectious disease referral hospital in Metro Manila, the Philippines, between 2006 and 2017. Cases were mapped and the distribution was compared with population density. Corynebacterium diphtheriae isolates from between 2015 and 2017 were examined by multilocus sequence typing (MLST).ResultsWe studied 267 patients (range:12−54 cases/year) admitted between 2006 and 2017. The case fatality rate (CFR) was 43.8% (95% confidence interval, 37.8−50.0%). A higher number of cases and CFR was observed among children <10 years. Mortality was associated with a delayed admission to hospital and a lack of diphtheria antitoxin. Between 2015 and 2017 there were 42 laboratory-confirmed cases. We identified 6 multilocus sequence types (STs). ST-302 was the most common (17/34, 48.6%), followed by ST67 (7/34, 20%) and ST458 (5/34, 14%). Case mapping showed a wide distribution of diphtheria patients in Metro Manila. Higher case numbers were found in densely populated areas but with no apparent clustering of ST types.ConclusionsOur analysis indicates that diphtheria remains endemic in Metro Manila and that the infection is frequently fatal in young children. Improved vaccine coverage and a sustainable supply of diphtheria antitoxin should be prioritized.

The Effect of Diphtheria AntiToxin (DAT) to Decrease Degrees of Diphtheria Severity

Background: Diphtheria incidence and mortality in Indonesia continue to increase from 2014-2017. DAT is critical to reduce the severity of diphtheria. The study aimed to determine the effect of DAT on reducing severity in diphtheria patients. Method: Analytical research with a case-control design. The research was conducted at RSPI Prof. Dr. Sulianti Saroso. The sample in this study was patients diagnosed with suspected diphtheria and diphtheria who received inpatient care at RSPI SS within a period of four years from 2014 to 2017. The cases in this study were 86 diphtheria-treated patients who were treated for 86 days, controls were 86 diphtheria-treated patients who were treated for &lt;10 days. Data were collected from medical records. Results: the variable associated with a decrease in severity of diphtheria sufferers was DAT (OR = 4,063; 95% CI: 1,354- 12,195, p = 0.012), corticosteroid administration (OR = 3,653, 95% CI 1.568-8,513, p = 0.003) and culture (OR = 0.170; 95% CI: 0.054-0,547), myocarditis is a confounding variable (OR = 1,690; 95% CI: 0.565- 5,052, p = 0.348). Conclusion: Provision of DAT has been shown to affect decreasing the severity of diphtheria.

ST534: the new sequence type of Corynebacterium diphtheriae causing diphtheria in Jakarta and surrounding areas, Indonesia

Background/aim The aim of this study was to find out characteristics and patterns of the spread of Corynebacterium diphtheriae isolated from Jakarta and the surrounding areas, using the whole genome sequencing (WGS) technique and multilocus sequence typing (MLST) approach.Materials and methods The study samples consisted of 86 C. diphtheriae isolates, which were isolated from diphtheria patients and close contacts of patients. The DNA sequencing was carried out using the WGS technique. Data conversion applied the U-gene software. Molecular typing was conducted through the MLST approach, then followed by online data analysis. Results The results showed that as many as 43 (50%) of all samples examined were new types with the same allele profile, namely 9-1-13-4-3-3-4. New sequence type C. diphtheriae is registered in the MLST global database as ST534 based on the allele profile. The tox gene analysis in 43 isolates with ST534 indicated that there were three mutation positions, all of which were silent mutations.Conclusion The main cause of diphtheria in Jakarta and the surrounding areas is a new sequence type of C. diphtheriae registered as ST534.

First-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae in Indonesia

BackgroundDiphtheria has been reported as an outbreak in some regions in Indonesia, most especially in East Java Province. Resistance to penicillin, erythromycin, and other antibiotics, single or multiple, has been reported in several studies. This study aims to evaluate the first-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae isolates.MethodsThis descriptive observational study was performed from August to November 2018. C. diphtheriae isolates were collected from diphtheria patients and carriers in East Java from 2012 to 2017 and kept at the Balai Besar Laboratorium Kesehatan Daerah Surabaya or the Public Health Laboratory of Surabaya. Sample selection was done by random cluster sampling. The sensitivity test by E-test®of the five antibiotics (penicillin, oxacillin, erythromycin, azithromycin, and clarithromycin) was done to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute M45A (2015) Corynebacterium spp. for penicillin and erythromycin was used as standard.ResultsFrom 114 targeted isolates, 108 were viable and toxigenic. The E-test was performed on the viable isolates. The majority of the hosts were male (58.3%), with median (range) age of 6.5 (1–14) years. Half of the samples were from the 1 to 5-year-old age group. The isolates were acquired much more from patients (78.7%) than carriers (21.3%) and from pharyngeal swab (74.1%). Most of these isolates were from Madura Island (47.2%) and the northern and eastern parts of the province (horseshoe area). Mitis isolates were the major variant (76.9%). The susceptibility pattern of C. diphtheriae to erythromycin was better than that to penicillin. The E-test result for penicillin was 68.52% susceptible, 31.48% intermediate, and 0% resistant (MIC range, < 0.016 to 2 μg/L) and for erythromycin (MIC range, < 0.016 to > 256 μg/L) was 85.2% susceptible, 12% intermediate, and 2.8% resistant The MIC range for oxacillin was 1 to 96 μg/L, while for both azithromycin and clarithromycin were < 0.016 to > 256 μg/L.ConclusionThe susceptibility rate of C. diphtheriae to erythromycin is higher than that to penicillin. The regular update of antibiotic selection to the national guidelines is recommended. The MIC reference standard to azithromycin and clarithromycin is also needed.

EPIDEMIOLOGY CHARACTERISTICS AND IMMUNIZATION STATUS OF DIPHTHERIA PATIENTS IN EAST JAVA PROVINCE IN 2018

Background: East Java Province is the region with the highest incidence of diphtheria in Indonesia. In the past three years, the number of diphtheria cases amounted to 758 cases and resulted in three mortalities. Objective: This study aims to describe the epidemiological characteristics and diphtheria immunization status of patients in East Java province in 2018. Methods: This study employed descriptive research with cross-sectional design. This study utilized secondary data of publication profiles from the East Java Provincial Health Office in 2018. The population was the entire diphtheria patients in East Java province, 2018. The samples were taken by using the total population sampling technique. The variables in this study were epidemiological characteristic and immunization status of diphtheria patients. The data analysis employed a univariate analysis by providing the frequency table. Results: Based on the records, diphtheria infected the children more often but, in 2018, it was also found in adults. This circumstance is proven by the findings that the patients were aged ≥19 years (33.11%) and were males (50.60%). In 2018, diphtheria patients number experienced an increase and decrease fluctuatingly as well as quite prevalence in some areas in the province of East Java. Diphtheria patients were predominanted by incomplete immunization status and unimmunized patients. Conclusion: The completeness status of diphtheria immunization has a very important role in the incidence of diphtheria cases in East Java Province in 2018, particularly the status of patients who is not complete and unimmunized.