Diphtheria in Hyderabad, India (2003–2006)
Author Information
Author(s): Bitragunta Sailaja, Murhekar Manoj V., Hutin Yvan J., Penumur Padmanabha P., Gupte Mohan D.
Primary Institution: National Institute of Epidemiology, Chennai, India
Hypothesis
What are the epidemiological patterns and vaccine efficacy of diphtheria in Hyderabad, India?
Conclusion
Diphtheria mainly affected children 5–19 years of age, particularly among girls and the Muslim population, with low booster coverage contributing to higher attack rates.
Supporting Evidence
- India contributed 71% of global diphtheria cases in 2005.
- Annual incidence of diphtheria increased from 11/100,000 to 23/100,000 from 2003 to 2006.
- 70% of case-patients were Muslim, with rates 3 times higher than other communities.
- Vaccine efficacy increased from 49% for 3 doses to 65% for 4 doses.
- Among children >5 years, efficacy for 5 doses was 91%.
Takeaway
Diphtheria is a serious disease that affected many kids in Hyderabad, especially girls and Muslims, and more booster shots are needed to keep everyone safe.
Methodology
The study included diphtheria case-patients admitted to Fever Hospital and analyzed vaccination status through interviews and medical records.
Potential Biases
Misclassification of vaccination status due to reliance on maternal recollection may have affected efficacy estimates.
Limitations
The study only included patients admitted to the hospital, potentially underestimating attack rates, and many children lacked vaccination cards.
Participant Demographics
Of the 2,685 case-patients, 70% were Muslim, with a median age of 17 years.
Statistical Information
P-Value
0.00001
Confidence Interval
95% CI 89%–90% for primary vaccination; 95% CI 59%–60% for fourth dose; 95% CI 33%–34% for fifth dose; 95% CI 0%–80% for 3 doses; 95% CI 8%–87% for 4 doses; 95% CI 68%–98% for 5 doses.
Statistical Significance
p<0.00001
Digital Object Identifier (DOI)
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