Diphtheria outbreak and associated risk factors assessment in Khyber Pakhtunkhwa, Pakistan

Authors

  • Wasia Ullah Department of Zoology, Abdul Wali Khan University Mardan 23300, Khyber Pakhtunkhwa, Pakistan.
  • Abdul Nasir Health Department, District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan.
  • Muhammad Izaz World Health Organization District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan.
  • Rabia Rabia Department of Animal Sciences, Quaid e Azam University, Islamabad 45320, Pakistan.

DOI:

https://doi.org/10.33687/xedf0s60

Keywords:

Diphtheria, Outbreak , Vaccination , Expanded program on Immunization , Public Health

Abstract

Diphtheria, a highly infectious disease that may be prevented by vaccine, is spreading and poses a serious threat of becoming an epidemic and major public health concern in Khyber Pakhtunkhwa, Pakistan. This study was aimed to examine the epidemic from an epidemiological standpoint and offer management recommendations in Khyber Pakhtunkhwa during the year 2024.

Data of Diphtheria cases were collected from Districts Health Information System (DHIS) of Health Department Khyber Pakhtukhwa for the year 2024 reported from 28 districts of the province. The data revealed 683 confirmed cases of diphtheria across 28 districts, underlining the significant public health issue faced by the disease's ability to spread rapidly. Among these, 58 cases were verified by laboratory testing, highlighting the critical need for improved diagnostic services to detect diphtheria rapidly and reliably. The study identifies six distinct outbreaks verified in laboratories in Peshawar Nowshera, Charsadda, Bannu, Mardan, and Swat, demonstrating the disease's widespread geographic reach and the need for focused public health interventions in these locations. A higher prevalence was identified in those over the age of five (87%). There is a substantial opportunity to reduce and ultimately extinguish the risk of diphtheria becoming an uncontrolled epidemic in the region by implementing a comprehensive and multifaceted approach.

 

Downloads

Download data is not yet available.

Author Biographies

  • Wasia Ullah , Department of Zoology, Abdul Wali Khan University Mardan 23300, Khyber Pakhtunkhwa, Pakistan.
    Department of Zoology, Abdul Wali Khan University.
  • Abdul Nasir, Health Department, District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan.
    Health Department, District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan
  • Muhammad Izaz, World Health Organization District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan.
    World Health Organization District Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan.
  • Rabia Rabia , Department of Animal Sciences, Quaid e Azam University, Islamabad 45320, Pakistan.

    Department of Animal Sciences, Quaid e Azam University, Islamabad 45320, Pakistan.

References

BalochA, ShahSZ, NoorZM, et al. The economic effect of refugee crises on neighbouring host countries: empirical evidence from Pakistan. Int Migr. 2017;55(6):90–106. doi:10.1111/imig.12389.

Braam D. Zoonotic Disease Dynamics in Displacement: A Multisite Case Study in Sindh, Pakistan and Mafraq, Jordan. University of Cambridge; 2022. doi:10.17863/CAM.96083.

Eisenberg N, Panunzi I, Wolz A, et al. Diphtheria antitoxin administration, outcomes, and safety: response to a Diphtheria outbreak in Cox’s Bazar, Bangladesh. Clin Infect Dis. 2021;73(7):e1713–e1718. doi:10.1093/ cid/ciaa1718.

Gunning CE, Mwananyanda L, MacLeod WB, et al. Implementation and adherence of routine pertussis vaccination(DTP)in a low-resource urban birth cohort. BMJ Open. 2020;10(12):e041198. doi:10.1136/bmjopen-2020-041198.

MacGregor, RR. Corynebacterium diphtheriae. In Mandell, GL, Bennett, JE, Dolin, R, eds. Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases, 7th edn. Philadelphia: Elsevier, 2009, pp. 2687–2693.

Oduoye MO, Marsool MDM, Haider MU, et al. Unmasking diphtheria in Nigeria: a multifaceted approach to tackle outbreaks and improve immunization rates among the Nigerian population—an updated correspondence. Health Sci Rep. 2024;7(1):e1804. doi:10.1002/hsr2.1804.

Pagliusi S, Che Y, Dong S. The art of partnerships for vaccines. Vaccine. 2019;37(40):5909–5919. doi:10.1016/j.vaccine.2019.07.088.

Rappuoli R, Malito E. History of Diphtheria Vaccine Development. In: Burkovski A, ed. Corynebacterium Diphtheriae and Related Toxigenic Species. Springer Netherlands; 2014:225–238. doi:10.1007/978-94-007-76241_11.

Review of Expanded Program on Immunization, Government of Khyber Pakhtunkhwa Pakistan, 31st December, 2024.

Sadoh, AE, Sadoh, WE. Diphtheria mortality in Nigeria: the need to stock diphtheria anti-toxin. African Journal of Clinical and Experimental Microbiology 2011; 12: 82–85.

Sein C, Tiwari T, Macneil A, et al. Diphtheria outbreak in Lao People’s Democratic Republic, 2012–2013. Vaccine. 2016;34(36):4321–4326. doi: 10.1016/j.vaccine.2016.06.074.

Siegel JD, Guzman-Cottrill JA. Pediatric Healthcare Epidemiology. In: Principles and Practice of Pediatric Infectious Diseases. Elsevier; 2018:10–25.

Truelove SA, Keegan LT, Moss WJ, et al. Clinical and Epidemiological Aspects of Diphtheria: A Systematic Review and Pooled Analysis. Clin Infect Dis. 2020;71(1):89–97. doi:10.1093/cid/ciz808.

Wazir A, Goujon A. Exploratory Assessment of the Census of Pakistan Using Demographic Analysis. J Off Stat. 2021;37(3):719–750. doi:10.2478/ jos-2021-0032.

World Health Organization. WHO-recommended standards for surveillance of selected vaccine-preventable diseases: May 2003 (www.who.int/vaccines-documents/).

World Health Organization. WHO position paper: diphtheria vaccine. Weekly Epidemiological Record 2006; 81: 24–31.

Yousaf F. Pakistan, Regional Security and Conflict Resolution: The Pashtun “tribal” Areas. Routledge; 2020.

Zwizwai R. Infectious diseases surveillance update. Lancet Infect Dis. 2023; 23(10):e407. doi:10.1016/S1473-3099(23)00585-6

Ricos Biology Vol. 2 No. 2

Downloads

Published

20-02-2025

Data Availability Statement

All the data described in the study are available in the manuscript

How to Cite

Diphtheria outbreak and associated risk factors assessment in Khyber Pakhtunkhwa, Pakistan. (2025). Ricos Biology, 3(2), 9-18. https://doi.org/10.33687/xedf0s60

Similar Articles

11-20 of 70

You may also start an advanced similarity search for this article.