Risk factors of diphtheria outbreak in damt district of Al Dhalea Governorate, 2023 -Yemen: a case–control study
BMC Infectious Diseases·
- DOI
- 10.1186/s12879-024-09932-7
- PMID
- 39333947
- PMCID
- PMC11429139
- OpenAlex
- W4402929401
- Study type
- Case-control study
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings highlight the need to increase vaccination coverage with diphtheria-containing vaccines through routine immunization and tetanus-diphtheria vaccination for childbearing-age females. Community awareness regarding protective measures during home care of diphtheria cases is recommended. Investigation of vaccination service delivery and gender barriers related to tetanus-diphtheria vaccination is warranted.
Structured evidence summary
Research question
The study aimed to identify risk factors associated with the 2023 diphtheria outbreak in Damt District, Al Dhalea Governorate, Yemen.
Study design
A retrospective matched case-control study with a 1:2 ratio was conducted. Cases were all confirmed diphtheria cases based on WHO case definition reported from Damt district during 2023, with two age-matched neighborhood controls recruited per case. Data were collected through household interviews using a pretested questionnaire covering demographics, household characteristics, diphtheria knowledge, vaccination status, case contact, and travel history.
Population and setting
The study enrolled 118 cases and 236 controls from Damt District, Al Dhalea Governorate, Yemen, during 2023. Fifty-six percent were female, with a median age of 14 years for cases and 12 years for controls. Among cases, females were significantly older than males.
Main findings
Poor vaccination coverage and contact with a diphtheria case were identified as the main contributors to diphtheria in Damt district, particularly among adult females. The study context noted a 57% increase in diphtheria cases nationwide in 2023 compared to 2021 and 2022, with Damt district reporting the highest number of cases for 2023.
Public-health relevance
The findings highlight the need to increase vaccination coverage with diphtheria-containing vaccines through routine immunization and tetanus-diphtheria vaccination for childbearing-age females. Community awareness regarding protective measures during home care of diphtheria cases is recommended. Investigation of vaccination service delivery and gender barriers related to tetanus-diphtheria vaccination is warranted.
Important limitations
This summary is limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade interpretation.
GIDS interpretation
This peer-reviewed case-control study from Yemen is discoverable through diphtheria, tetanus, outbreak investigation, vaccination, and Yemen classifiers. It provides context on risk factors during a 2023 district-level outbreak in a conflict-affected setting with health system fragility.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 13 auditable classifier relationships to diseases, places, topics, and study design.