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Volume 25, Number 10—October 2019
Synopsis

Global Epidemiology of Diphtheria, 2000–20171

Kristie E.N. ClarkeComments to Author , Adam MacNeil, Stephen Hadler, Colleen Scott, Tejpratap S.P. Tiwari, and Thomas Cherian2
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K.E.N. Clarke, A. MacNeil, S. Hadler, C. Scott, T.S.P. Tiwari); World Health Organization, Geneva, Switzerland (T. Cherian)

Main Article

Table 2

Overview of datasets with information on age and vaccination status compiled from review compared with aggregate diphtheria incidence data reported by countries on the joint reporting form over the same period, 2000–2017*

Country Classification Full dataset, 
n = 15,380
 Datasets for sensitivity analysis
Age data, 
n = 9,334†
 Vaccination status data, n = 1,534‡
 Joint reporting form data 2000–2017, n = 103,138
Years of data Total cases Years of data Total cases Years of data Total cases Years ≥1 case reported Total cases
Afghanistan Higher case count 1 50 1 37 NA NA 8 1,380
Australia Sporadic 1 1 1 1 1 1 7 26
Austria Sporadic 1 2 1 2 NA NA 2 4
Bangladesh§ Higher case count 1 3,581 1 3,567 NA NA 18 804
Belgium Sporadic 2 2 2 2 1 1 7 15
Brazil Higher case count 3 32 2 28 3 32 16 331
Colombia Sporadic 1 8 1 8 1 6 4 17
Dominican Republic Higher case count 2 82 2 82 1 1 15 372
Finland Sporadic 2 2 2 2 2 2 3 3
France Sporadic 7 22 7 22 4 4 10 54
Germany Sporadic 7 24 7 24 3 3 13 77
Haiti Higher case count 6 314 3 92 3 41 14 230
India¶ Higher case count 20 8,720 18 3,303 12 544 18 79,034
Indonesia Higher case count 2 582 2 566 1 52 17 7,160
Italy Sporadic 1 1 1 1 NA NA 1 1
Laos Higher case count 2 62 2 62 2 27 15 578
Latvia Higher case count 10 133 10 133 6 45 18 612
Lithuania Sporadic 2 3 2 3 NA NA 4 10
Malaysia Higher case count 1 1 1 1 NA NA 14 106
Myanmar Higher case count 2 156 2 154 1 50 17 512
Netherlands Sporadic 3 5 3 5 3 4 5 12
Nigeria Higher case count 6 118 6 118 3 8 4 7,565
Norway Sporadic 3 8 3 8 1 3 3 5
Pakistan Higher case count 2 406 2 406 2 372 18 1,176
Paraguay Sporadic 1 47 NA NA 1 12 5 59
Philippines Higher case count 7 553 7 512 6 280 15 1,019
South Africa Sporadic 1 15 1 15 1 8 6 26
Spain Sporadic 2 2 2 2 2 2 2 2
Sweden Sporadic 6 12 6 12 5 7 6 12
Thailand Higher case count 2 47 2 35 NA NA 18 342
United Kingdom Sporadic 8 23 8 22 4 4 13 40
United States Sporadic 1 1 1 1 1 1 5 6
Venezuela Higher case count 2 244 NA NA 1 11 3 818
Vietnam Higher case count 2 121 1 108 1 13 18 730

*NA, not available.
†Includes all case-patients for which age was clearly designated as above or below an age cutoff point of 15 y (± 1 y).
‡Includes all cases for which vaccination status was clearly designated as fully vaccinated, partially vaccinated, or unvaccinated.
§Population of Rohingya refugees from Myanmar housed in a refugee camp in Bangladesh.
¶Data from India include 2 articles with aggregate data including the late 1990s (Appendix references 15,18).

Main Article

1Preliminary results from this study were presented at the meeting of the Strategic Advisory Group of Experts on Immunization, Geneva, Switzerland, April 25–27, 2017.

2Retired.

Page created: September 17, 2019
Page updated: September 17, 2019
Page reviewed: September 17, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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