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Nigeria Face Second Wave of Diphtheria

Nigeria Face Second Wave of Diphtheria

Nigeria is currently facing a second wave of diphtheria outbreaks.

Daily Report Nigeria reports that the first wave of Diphtheria outbreak was recorded between week 52 of 2022 and May 2023.

The second wave follows as the affected population grew and the number of confirmed infections and related deaths rose, according to Thursday’s World Health Organization (WHO) situation report.

According to the WHO’s report, since the outbreak was first reported in 2022, Nigeria has reported 4,717 cases out of 8,353 suspected cases.

The report disclosed most of the suspected cases were reported from Kano, Katsina, Yobe, Bauchi, Kaduna, and Borno states.

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The report revealed that between June 30, 2023, and August 31, 2023, Nigeria recorded an unusual increase in the number of confirmed cases of diphtheria in 59 local governments in 11 states across the country.

According to the WHO’s latest risk assessment of the diphtheria outbreak in Nigeria, the risk was high at the national level and low at the regional and global levels.

However, in response to the outbreak, the Nigeria Center for Disease Control and Prevention NCDC, in collaboration with the WHO and other partners, has coordinated efforts to improve vaccination efforts and strengthen surveillance for early detection of cases, case management, and risk communication among the public.

The statement read:
Of the cumulative 8,353 suspected cases reported since the outbreak was first reported in 2022, 4.717 (56.5 per cent) cases were confirmed (lab confirmed 1 (169; 3.6 per cent), epidemiologically linked (117; 2.5 per cent) and clinical compatibility (4,431; 93.9 per cent)). While 1,857 (22.2 per cent) were discarded as not compatible with diphtheria, 1,048 (12.5 per cent) cases are pending classification, and 731 (8.8 per cent) cases had unknown diagnoses.

“The case fatality ratio dropped slightly from 6.7 per cent during the last update to 6.1 per cent. Of the 4,717 confirmed cases, 3,466 (73.5 per cent) were aged one to 14 years, of these 699 were aged zero to four years, 1,505 were aged five to nine years, and 1,262 (aged 10 – 14 years. More than half of the cases (2,656; 56.3 per cent) were females.

“Only 1,074 (22.8 per cent) of the confirmed cases were fully vaccinated against diphtheria, 299 (6.3 per cent) were partially vaccinated. More than half of the cases (2801; 59.4 per cent) were unvaccinated.”

Treatment included administration of diphtheria antitoxin and antibiotics.

Vaccination against diphtheria has dramatically reduced mortality and morbidity from diphtheria.

Nigeria has recorded diphtheria outbreaks in the past, particularly in 2011 and 2022.

Diphtheria is a highly contagious, vaccine-preventable disease caused primarily by the bacterium Corynebacterium diphtheriae and can be fatal in 5 to 10 percent of cases, with mortality rates higher in young children.

WHO said:

Nigeria is currently facing a second wave of diphtheria outbreak after a first wave of the outbreak was recorded between epidemiological week 52, 2022 (January 1, 2023) and week 20, 2023 (May 22, 2023). There is an increase in the affected population with a rise in the number of confirmed cases and related deaths reported in epidemiological weeks 31-33.

“There is an increased risk of transmission, with clusters and outbreaks reported in newly affected LGAs, with currently 27 LGAs reporting one clinically compatible case in the last three reporting weeks relative to 15 LGAs that had active cases in the preceding three weeks.

“The low national coverage (57 per cent) of the Pentavalent vaccine (Penta 3) administered in routine immunisation, and the sub-optimal vaccination coverage in the paediatric population—with 43 per cent of the target population unvaccinated—underscore the risk of further spread and the accumulation of a critical mass of susceptible population in the country with sub-optimal herd or population immunity.”

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