Global strategies for addressing diphtheria resurgence epidemiology clinical impact and prevention

Abstract

Aim: Diphtheria, caused by Corynebacterium diphtheriae, is still a major global health concern. This study aims to investigate the resurgence of diphtheria. Methods: We conducted a narrative review on Scopus, PubMed, and Google Scholar with no limitation on publication date for pertinent articles published in English that were succinctly discussed under several headings. Results: Diphtheria epidemiology has changed considerably since the 1970s, but outbreaks still occur due to gaps in vaccination, infrastructure failures, and civil unrest, particularly in countries like Venezuela, Yemen, and Bangladesh. The COVID-19 pandemic has exacerbated these challenges, particularly in low-resource regions like Nigeria. According to recent estimates, diphtheria epidemics are on the rise, especially in low-resource areas with poor sanitation and immunization rates. Antimicrobial resistance, the pathogenicity of disease-producing bacteria, and behavioral variables are some factors triggering this return. Transmission occurs via droplet spread for respiratory/oropharyngeal diphtheria and through direct person-to-person contact for the cutaneous form of diphtheria with pathogenesis involving toxin production leading to local and systemic effects. However, underreporting and low coverage persist, especially in Africa and Southeast Asia, leading to higher fatality rates. The resurgence of diphtheria brings to light more significant public health consequences, such as pressure on healthcare systems and socioeconomic effects. Maintaining robust immunization strategies and strengthening public health systems is crucial for global control, in addition to a comprehensive approach to combat the diphtheria resurgence, including assessing vaccine coverage rates, identifying barriers to vaccination, and improving immunization uptake, particularly in at-risk populations. Laboratory diagnosis is crucial for confirming cases, and preventive measures include immunization programs, early antibiotic administration, and outbreak control strategies. Management involves prompt administration of antitoxin and antibiotic therapy, patient isolation, and supportive care. Comprehensive global standards that highlight the value of vaccination, bolster the healthcare system, and implement measures to encourage vaccine uptake are required to address these issues. To maintain sustainable control of diphtheria epidemics and safeguard public health worldwide, long-term policies should include boosting funding for immunization programs, improving disease surveillance, and building collaborations. Conclusion: Long-term policies including boosting funding for immunization programs, improving disease surveillance, and building collaborations are expedient.