Diphtheria Mortality in North Western Nigeria: A Review of Ninety-eight Consecutive Cases

BACKGROUND: Diphtheria is a vaccine-preventable infection with high mortality rates due to toxin-mediated complications. OBJECTIVE: This study outlines the clinical patterns and outcomes of diphtheria patients at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. METHODOLOGY: A retrospective study of children aged 0-15 years managed for diphtheria between January 2017 and October 2024. RESULTS: Ninety-eight suspected cases were observed, with 48 (49%) confirmed by culture. The mean age was 7 ± 3.30 years, with a female preponderance (61.2%). Most patients presented with fever, sore throat, and bull neck. Only 17 (17.0%) had previous immunization. The mortality rate was high (75.5%), with causes of death including myocardial involvement (38.4%), acute renal failure (9.6%), cardiorenal failure (43.8%), and respiratory failure (8.2%). CONCLUSION: This study highlights the need for diphtheria antitoxin availability in Nigeria due to the high mortality rate. Health education on routine childhood immunization is crucial to prevent this deadly disease. The government needs to take action to make antitoxin available and promote immunization.