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Nigeria: Diphtheria Outbreak - Jan 2023

Disaster description

There has been an alarming increase in the diphtheria in Nigeria since early 2023, which worsened in March. The suspected cases reported increased from 136 cases in Week 1 of 2023 to 253 cases by Week 4. As of 2nd March 2023, Nigeria Centre for Disease Control (NCDC) recorded again further increase of the disease. In the total of 733 suspected cases, including 89 deaths, children between the ages of 5 and 18 are the age group most afflicted. The overall case fatality rate is (12.3%). The latest data received by the World Health Organization (WHO) from ProMed reported that 20 states are currently reporting suspected cases. This outbreak has been labelled as one of the most severe outbreaks of diphtheria in Nigeria in recent years. (IFRC, 15 Mar 2023)

Since the beginning of 2023, 557 confirmed cases of diphtheria have been detected in Nigeria, affecting 21 of the 36 states and the Federal Capital Territory. (WHO, 27 Apr 2023)

The Nigeria Centre for Disease Control and Prevention (NCDC) is aware of the death in June 2023 of a four-year-old with diphtheria in the Federal Capital Territory (FCT), Abuja. The NCDC, since December 2022, has reported multiple diphtheria outbreaks in different states across the country. As of June 30th, 2023, there have been 798 confirmed diphtheria cases from 33 Local Government Areas (LGAs) in eight (8) States including the FCT. Most of the cases (782) were recorded in Kano. Other States with cases are Lagos, Yobe, Katsina, Cross River, Kaduna, and Osun. The majority (71.7%) of the 798 confirmed cases occurred among children aged 2 – 14 years. So far, a total of 80 deaths have been recorded among all confirmed cases (case fatality rate of 10.0%). (GOV, 6 Jul 2023)

UNICEF Nigeria is amplifying its efforts to counter a growing outbreak of diphtheria that has affected children in 27 states. As of July 2023, 3,850 suspected cases were reported with 1,387 confirmed as diphtheria. The disease has tragically claimed 122 lives, with a case fatality rate (CFR) of 8.7%. The outbreak has affected mainly Kano, Yobe, Katsina, Lagos, FCT, Sokoto, and Zamfara, which account for 98.0% of the suspected cases. Most confirmed cases, approximately 71.5%, have occurred among children aged 2–14 years. (UNICEF, 3 Aug 2023)

Between week 19, 2022 and week 31, 2023, 4 160 suspected cases of diphtheria were reported from 27 states in Nigeria. Kano (3 233), Yobe (477), and Katsina (132) States have reported the most cases. A total of 137 deaths were recorded among confirmed cases (CFR 7.5%). Of suspected cases, 1 534 were confirmed, including 87 laboratory confirmed, 158 epidemiologically linked, and 1 289 clinically compatible. (WHO, 27 Aug 2023)

With low national vaccination coverage and a worldwide shortage of lifesaving antitoxin threatening to worsen the outbreak, Médecins Sans Frontières (MSF) urges the international community to immediately scale up support to improve treatment, preventive measures and contact tracing to control the outbreak’s spread. “We’re currently seeing more than 700 people with suspected diphtheria and admitting more than 280 patients on a weekly basis in Kano state’s two diphtheria treatment centres,” says Dr Hashim Juma Omar, MSF emergency project medical doctor. “Women and children aged under five are the most vulnerable groups and are the people most affected right now in Kano state. And they really need help.” (MSF, 18 Sep 2023)

Between week 19, 2022 and week 31, 2023, 4 160 suspected cases of diphtheria were reported from 27 states in Nigeria. Kano (3 233), Yobe (477), and Katsina (132) States have reported the most cases. A total of 137 deaths were recorded among confirmed cases (CFR 7.5%). Of suspected cases, 1 534 were confirmed, including 87 laboratory-confirmed, 158 epidemiologically linked, and 1 289 clinically compatible. (WHO, 9 Nov 2023)

The outbreak has reached alarming proportions, with 32 states affected, and 12 states experiencing severe cases. Kano State reports the highest number of new infections, with Yobe state also facing a serious situation, resulting in the tragic loss of 117 children, according to the National Primary Healthcare Development Agency. (IFRC, 6 Dec 2023)

Between week 19 of 2022 and week 6 of 2024, a total of 27 078 suspected cases of diphtheria were reported from 36 states in Nigeria. Among these cases, 16 603 were confirmed, comprising 365 laboratory-confirmed, 483 epidemiologically linked, and 15 755 clinically compatible cases. (WHO, 24 Mar 2024)

From week 1 to week 8 of 2024, 417 suspected diphtheria cases and 16 deaths (CFR 3.8%) were reported in the BAY States in 23/65 LGA (Adamawa 2 cases, 0 deaths; Borno 271 cases, 14 deaths; Yobe 144 cases, 2 deaths).(WHO, Govt. Nigeria 9 Apr 2024)

Between weeks 1 and 10 of 2024, a total of 4 178 diphtheria cases have been reported in Nigeria, including 2 009 confirmed cases and 30 deaths (WHO, 12 May 2024)

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