Observational studyBMC infectious diseases2025
Clinical presentation and predictors of hospital mortality of diphtheria in Nigeria, July 2023 to April 2024: a single-center study.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- CLINICO-Demographic Profile and Outcomes of Hospitalised Children With Diphtheria in A Tertiary Care Hospital of Peshawar.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- The menace and outcome of severe acute malnutrition and diphtheria cases among paediatric under-five in-patients at Nguru North - east Nigeria.BMC infectious diseases · 2026Article
- Clinical features, prognosis, and treatment outcomes of diphtheria in children: a retrospective cohort study at children's hospital, Sukkur.BMC infectious diseases · 2026Article
- Putting Out the Fire before it becomes an Inferno: Responding to an Outbreak of Diphtheria in Edo State, Nigeria.Nigerian medical journal : journal of the Nigeria Medical AssociationReview
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite recurrent outbreaks of diphtheria in Nigeria, there is a lack of in-depth analysis of hospitalization outcomes. Herein, we describe the sociodemographic, clinical, and laboratory features associated with hospitalization outcomes (defined as death or discharge) during the recent diphtheria outbreak in Nigeria.
methodsThis prospective observational study included 246 confirmed diphtheria cases managed in a dedicated isolation ward of a health facility in northwestern Nigeria from July 1, 2023, to April 30, 2024. We analyzed clinical and laboratory features, immunization status, and socio-demographics in relation to hospitalization deaths using SPSS version 29.
resultsThe median age (interquartile range) was 7.00 (4-10) years and 49.6% (122) were aged 5-10 years. Common clinical features were fever (95.9%), sore throat (91.9%), painful swallowing (90.7%), pseudomembrane (93.1%), and cervical-submandibular lymphadenopathy (91.5%). Most children were unvaccinated (158; 64.2%), 199 (80.9%) received diphtheria antitoxin, and both were related to outcomes. Mortality rate was 23.5% (58/246). After adjusting for confounders, predictors of hospitalization deaths were neck swelling with an adjusted odds ratio (AOR) of 9.80 (95% CI 1.68-56.47), abnormal respiratory findings (AOR, 149.99 [95% CI, 15.60-1442.02] ), hypoxemia (AOR, 37.79 [95% CI, 4.26-331.96] ), and elevated serum creatinine above 1.5 mg/dL (AOR 107.78, 95% CI, 7.94-1462.38).
conclusionsDiphtheria is a significant burden in Nigeria, particularly among children. Neck swelling, hypoxemia, abnormal respiratory findings, and impaired renal function were predictive of hospitalization death. Although antitoxin and vaccination were related to outcomes, they did not predict hospitalization death.
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