TY - JOUR
T1 - Global epidemiology of diphtheria, 2000-2017
AU - Clarke, Kristie E.N.
AU - MacNeil, Adam
AU - Hadler, Stephen
AU - Scott, Colleen
AU - Tiwari, Tejpratap S.P.
AU - Cherian, Thomas
N1 - Funding Information:
Diphtheria data from the European Surveillance System were provided by Spain, Latvia, Germany, Italy, Lithuania, the Netherlands, the United Kingdom, Finland, Sweden, France, Austria, and Belgium and released by the European Centre for Disease Prevention and Control (Stockholm, Sweden) (Appendix reference 60). Similar case-based diphtheria data were not available from other regions. Because of multiple data sources, we conservatively excluded cases identified as potential duplicates when matching by age group, location, and year. The final dataset consisted of 15,380 cases of diphtheria (15,068 including age data and 7,242 including vaccination status data) from 34 countries.
Publisher Copyright:
© 2019 Centers for Disease Control and Prevention (CDC). All rights reserved.
PY - 2019
Y1 - 2019
N2 - In 2017, a total of 8,819 cases of diphtheria were reported worldwide, the most since 2004. However, recent diphtheria epidemiology has not been well described. We analyzed incidence data and data from the literature to describe diphtheria epidemiology. World Health Organization surveillance data were 81% complete; completeness varied by region, indicating underreporting. As national diphtheria-tetanus-pertussis (DTP) 3 coverage increased, the proportion of case-patients <15 years of age decreased, indicating increased protection of young children. In countries with higher case counts, 66% of case-patients were unvaccinated and 63% were <15 years of age. In countries with sporadic cases, 32% of case-patients were unvaccinated and 66% were >15 years of age, consistent with waning vaccine immunity. Global DTP3 coverage is suboptimal. Attaining high DTP3 coverage and implementing recommended booster doses are necessary to decrease diphtheria incidence. Collection and use of data on subnational and booster dose coverage, enhanced laboratory capacity, and case-based surveillance would improve data quality.
AB - In 2017, a total of 8,819 cases of diphtheria were reported worldwide, the most since 2004. However, recent diphtheria epidemiology has not been well described. We analyzed incidence data and data from the literature to describe diphtheria epidemiology. World Health Organization surveillance data were 81% complete; completeness varied by region, indicating underreporting. As national diphtheria-tetanus-pertussis (DTP) 3 coverage increased, the proportion of case-patients <15 years of age decreased, indicating increased protection of young children. In countries with higher case counts, 66% of case-patients were unvaccinated and 63% were <15 years of age. In countries with sporadic cases, 32% of case-patients were unvaccinated and 66% were >15 years of age, consistent with waning vaccine immunity. Global DTP3 coverage is suboptimal. Attaining high DTP3 coverage and implementing recommended booster doses are necessary to decrease diphtheria incidence. Collection and use of data on subnational and booster dose coverage, enhanced laboratory capacity, and case-based surveillance would improve data quality.
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U2 - 10.3201/eid2510.190271
DO - 10.3201/eid2510.190271
M3 - Article
C2 - 31538559
AN - SCOPUS:85072379160
SN - 1080-6040
VL - 25
SP - 1834
EP - 1842
JO - Emerging infectious diseases
JF - Emerging infectious diseases
IS - 10
ER -