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Journal of Tropical Pediatrics 1985 31(1):8-12; doi:10.1093/tropej/31.1.8
© 1985 by Oxford University Press
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An Epidemiological Study of the 1978 Outbreak of Diphtheria in Khartoum Province

Mustafa Abdalla M. Salih, Faculty of Medicine1, Fathi El Hakeem, Assistant Commissioner for Health2, Gaafar I. Suliman3, Hassan S. Hassan4 and Awad S. El Khatim5

1Department of Paediatrics and Child Health University of Khartoum
2Department of Maternity and Child Health, Ministry of Health
3Children's Emergency Hospital Khartoum
4Department of Bacteriology, National Health Laboratory
5 Khartoum Province

Public health measures carried out to control an outbreak of diphtheria in Khartoum Province of the Sudan in the year 1978 are reviewed. This involved the search for cases and carriers among contacts by inspection and swabbing. Nose and throat swabs were obtained from 1266 contacts of whom 1039 were home contacts and 227 were school contacts. Twenty-nine carriers were identified; 14(48:3 per cent) were 6–10 years of age and 8(27.6 percent) were in the 11–15 years age group. The number of throat and nasal carriers were 24 and 5 respectively. The isolated corynebacterium diphtheriae was of the gravis type but showed the unusual property of fermenting sucrose. It was toxogenic to guinea pigs in 22 cases. All contacts received benzathine penicillin G: 600 000 units for children at or below 5 years of age and 1.2 million units for the rest. Prophylactic antitoxin administration (10 000 units) was started in contacts and stopped shortly because it resulted in severe hypersensitivity reactions in 7 per cent of the first 231 who had it. Carriers were isolated, had diphtheria antitoxin (10 000 units) and procaine penicillin (one million units daily for 7 days). The methodology, difficulties and results in this study are discussed and compared with similar experiences in Africa and elsewhere.


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