ABSTRACT
Infection with Corynebacterium diphtheriae persists in Haiti. Twenty-six children with clinically severe respiratory diphtheria presented to a hospital in northern Haiti during a 3-year period beginning in early 2015. The mortality rate was 50%. Partial or absent vaccinations as well as delayed and limited care contributed to mortality. This cohort offer insights into the multiple challenges involved in preventing and caring for children with diphtheria in resource-limited settings.
Subject(s)
Corynebacterium diphtheriae/isolation & purification , Diphtheria/diagnosis , Respiratory Tract Infections/complications , Respiratory Tract Infections/microbiology , Child , Cohort Studies , Delayed Diagnosis , Diphtheria/drug therapy , Diphtheria/microbiology , Diphtheria/mortality , Diphtheria Antitoxin/administration & dosage , Female , Haiti/epidemiology , Health Services Accessibility , Humans , Immunization , Respiratory Tract Infections/epidemiology , VaccinationSubject(s)
Humans , Anthrax/mortality , Brucellosis/mortality , Whooping Cough/mortality , Cholera/mortality , Diphtheria/mortality , Chagas Disease/mortality , Morbidity , Mandatory Reporting , Chile , Echinococcosis/mortality , Paratyphoid Fever/mortality , Typhoid Fever/mortality , Gonorrhea/mortality , Hepatitis A/mortality , Hepatitis B/mortality , Hepatitis/mortality , Malaria/mortality , Parotitis/mortality , Rubella/mortality , Measles/mortality , Syphilis/mortality , Hantavirus Pulmonary Syndrome/mortality , Trichinellosis/mortality , Tuberculosis/mortality , Tetanus/mortalityABSTRACT
OBJECTIVE: To determine the prognosis in patients with diphtherial myocarditis and bradyarrhythmias and to assess the results of ventricular pacing in those with third degree atrioventricular block. DESIGN: Case series. SETTING: Referral department of cardiology in a teaching hospital. PATIENTS: Twenty four out of 46 patients admitted with diphtherial myocarditis over 10 years had bradyarrhythmias. Six had sinus bradycardia, 15 atrioventricular or intraventricular conduction disturbances, and three atrioventricular dissociation. MAIN OUTCOME MEASURE: Death rate. RESULTS: Eleven patients died (46%): all seven patients with third degree atrioventricular block, the patient with bifascicular block, and three of the six patients with bundle branch block. Seven died of cardiogenic shock and four of ventricular fibrillation. All nine patients with sinus bradycardia or atrioventricular dissociation survived. CONCLUSION: Conduction system disturbances in patients with diphtherial myocarditis are markers of severe myocardial damage and a poor prognosis. In addition, ventricular pacing does not improve survival.
Subject(s)
Bradycardia/complications , Cardiac Pacing, Artificial , Diphtheria/complications , Myocarditis/complications , Adolescent , Bradycardia/mortality , Bradycardia/therapy , Child , Child, Preschool , Diphtheria/mortality , Diphtheria/therapy , Female , Heart Block/mortality , Heart Block/therapy , Humans , Male , Myocarditis/mortality , Myocarditis/therapy , PrognosisSubject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Diphtheria/epidemiology , Corynebacterium diphtheriae/pathogenicity , Diphtheria-Tetanus-Pertussis Vaccine/therapeutic use , Diphtheria/mortality , Diphtheria/pathology , Diphtheria/prevention & control , Retrospective StudiesABSTRACT
Estuda-se a evoluçäo da morbidade e da mortalidade por difteria, distribuídos por grupos de idade, na cidade do Recife, no período de 1973-82. Säo utilizados para análise, dados fornecidos pelas Diretorias de Informática e de Epidemiologia da Secretaria de Saúde do Estado de Pernambuco/Fundaçäo de Saúde Amaury de Medeiros. A distribuiçäo etária apresentada é a existente na Instituiçäo: menores de 1 ano, 1 a 4 anos e 5 a 14 anos. Observa-se que a incidência näo apresenta maiores modificaçöes. Os valores da equaçäo da linha reta mostram o comportamento no período. Os dados referentes à cobertura vacinal evidenciam uma utilizaçäo inadequada deste recurso. A queda da mortalidade observada no período deve-se a uma reduçäo na letalidade verificada principalmente em crianças de 1 a 4 e 5 a 14 anos. Esta reduçäo pode traduzir uma melhor assistência ao doente
Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Diphtheria/mortality , Brazil , Retrospective Studies , Socioeconomic FactorsABSTRACT
Del estudio prospectivo clínico y epidemiológico con relación a la letalidad, en 118 niños con difteria atendidos de 1975 a 1981 en el hospital Belen de Trujillo, se obtuvo una incidencia de 9.5 por 1000 hospitalizados de 0-14 años. La mayor frecuencia en el sexo masculino y en climas templados fueron poco significativos. Al ingreso, un tiempo de enfermedad mayor a dos días, edades menores a 6 años, procedencia sub-urbana, carencia de inmunización completa, formas clínicas faringo-amigdalares con compromiso laríngeo o no, toxemia evidente y cuello proconsular, significaron gravedad y riesgo. La seudomembrana estuvo presente en 94%, la fiebre en 86%, dolor de garganta, disfagia y adenopatía submaxilar en 60%, toxemia evidente en 55% y cuello proconsular en 35%, 80% del total de complicaciones fueron miocárdicas, 15.7% neurológicas y 4.3% trastornos hemorrágiperos, las primeras significaron gravedad y riesgo. La letalidad por difteria fue 12.7%
Subject(s)
Humans , Infant , Child, Preschool , Child , Male , Female , Diphtheria/complications , Diphtheria/mortality , Diphtheria/pathology , Diphtheria/epidemiology , Child, HospitalizedSubject(s)
Diphtheria/epidemiology , Adolescent , Child , Child, Preschool , Chile , Diphtheria/mortality , Diphtheria/prevention & control , Diphtheria Toxoid , Female , Humans , Infant , Infant, Newborn , MaleSubject(s)
Diphtheria/mortality , Immunization Schedule , Measles/mortality , Poliomyelitis/mortality , Whooping Cough/mortality , Adolescent , Adult , Aged , Child , Child, Preschool , Chile , Female , Humans , Infant , Male , Middle Aged , National Health Programs , Retrospective StudiesABSTRACT
Two surveys of cases of diphtheria occurring between the years 1964 and 1971 in hospital populations of Kingston and St. Andrew were studied. The results were analysed to determine the extent of the disease and to indicate the most susceptible groups in the community. It was found that the susceptible group consisted of non-immunised children under 5 years of age, from areas where there was over-crowding, poor housing and sanitation. Using these results as a guide, Schick Testing was carried out on children in a low income suburb and the results analysed. This showed a high degree of susceptibility in the non-immunised children, especially the 1 and 2 year olds, and also showed some degree of protection among children who had no record of any immunisations (Summary)
Subject(s)
Humans , Infant , Child, Preschool , Child , Male , Female , Diphtheria , Jamaica , Hospitalization/statistics & numerical data , Socioeconomic Factors , Immunization , Diphtheria-Tetanus-Pertussis Vaccine , Diphtheria/mortalitySubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Diphtheria/epidemiology , Diphtheria/mortality , Antigua and Barbuda , Mortality , West Indies , HousingABSTRACT
An analysis is presented of 1890 consecutive admissions to the children's ward of University College Hospital in the four years 1955-1958. 1090 were under the age of two years, 197 of these died. 800 were between two and thirteen years of age with 56 deaths. In the under two age group the commonest diseases are malnutrition (26 percent) and gastro-enteritis (25 percent). These two diseases together are responsible for 57« of the deaths. The majority of these cases could be prevented by the provision of enough suitable cheap food and by the education of the mothers in infant feeding. In the over two age group malnutrition and gastroenteritis are of insignificant proportion and there is a wide range of diagnoses similar to those found in temperate climates. The frequency of rheumatic fever and heart disease is emphasized. Diphtheria is an important cause of morbidity and mortality which should be prevented (AU)
Subject(s)
Humans , Child , Pediatrics , Pattern Recognition, Automated , Child Nutrition Disorders/mortality , Gastroenteritis/mortality , Diphtheria/mortalityABSTRACT
Duración media de vida en La Rioja, San Juan y Mendoza; Ensayo de nuevas bases y orientaciones para la protección e higiene materno-infantil en el interior; Sífilis congénita y organización de la lucha contra el peligro heredo-luético; Difteria; Lucha antibociosa; Función higiénico-social del dispensario en la lucha contra la mortalidad infantil
Subject(s)
Argentina , Goiter, Endemic/prevention & control , Goiter/prevention & control , Diphtheria/epidemiology , Syphilis, Congenital/epidemiology , Diphtheria Toxoid/therapeutic use , Goiter, Endemic/therapy , Goiter, Endemic/drug therapy , Goiter/therapy , Goiter/drug therapy , Prenatal Care , Diphtheria/mortality , Life Expectancy , Socioeconomic Factors , Risk Groups , Legislation as Topic , Sanitary Surveys, Water Supply , Preventive Medicine , Social Medicine , Infant Mortality , Health Programs and Plans , Health Policy , Immunization Programs , Health Promotion , Medical Records , Maternal and Child Health , Preventive Health Services , Syphilis, Congenital/mortality , Syphilis, Congenital/prevention & control , Diphtheria Toxoid/administration & dosage , Diphtheria Toxoid/immunologyABSTRACT
Duración media de vida en La Rioja, San Juan y Mendoza; Ensayo de nuevas bases y orientaciones para la protección e higiene materno-infantil en el interior; Sífilis congénita y organización de la lucha contra el peligro heredo-luético; Difteria; Lucha antibociosa; Función higiénico-social del dispensario en la lucha contra la mortalidad infantil