kjhs Volume. 3, Issue 2 (2023)


Makeri D., Peter, P.D., Pius, T.


Corynebacterium diphtheriae Diphtheria Nigeria Outbreak Resurgence Incomplete vaccination; Children

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

Abstract: 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., < 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.