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