Clinical presentation and predictors of hospital mortality of diphtheria in Nige

A single-center study conducted in Nigeria between July 2023 and April 2024 focused on the clinical presentation and predictors of hospital mortality in patients diagnosed with diphtheria. The study aimed to identify the key factors that contribute to a higher risk of death in patients with this infectious disease and to improve understanding of its clinical manifestations in the Nigerian context.

Diphtheria, a bacterial infection caused by *Corynebacterium diphtheriae*, has seen a resurgence in several regions of Nigeria in recent years. Despite the availability of a vaccine, which has significantly reduced the incidence of diphtheria in many countries, Nigeria has faced challenges with maintaining vaccination coverage and addressing outbreaks. The clinical presentation of diphtheria varies, but it typically includes sore throat, fever, and the formation of a pseudomembrane in the throat that can obstruct the airway, leading to severe respiratory distress.

The study highlighted that the most common clinical symptoms observed in hospitalized diphtheria patients included fever, sore throat, difficulty swallowing, and difficulty breathing. Some patients presented with complications such as myocarditis, neuropathy, and severe respiratory distress, which contributed to the need for intensive care and mechanical ventilation in certain cases. Early identification and management of these complications were crucial in determining patient outcomes.

The study also identified several predictors of hospital mortality in patients with diphtheria. These included advanced age, presence of comorbidities, such as diabetes and hypertension, the severity of respiratory distress, and delayed presentation to the hospital. Patients who arrived late for treatment, particularly those with airway obstruction or myocarditis, were found to have a higher risk of mortality. Additionally, a history of incomplete vaccination or lack of vaccination against diphtheria was a significant risk factor for poor outcomes.

The findings of this study underscore the importance of early diagnosis and prompt treatment in reducing mortality rates among patients with diphtheria. It also highlights the need for increased vaccination efforts and public health campaigns to ensure that the population, particularly children and high-risk individuals, are protected against this preventable disease. Strengthening healthcare infrastructure and access to critical care resources, such as ventilators and antitoxin treatment, are essential to improving patient survival rates in future outbreaks. The study calls for further research to develop more effective therapeutic strategies and preventive measures to combat diphtheria in Nigeria.

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