CHARACTERISTIC OF PEDIATRIC PATIENT INITIALLY DIAGNOSED WITH DIPHTHERIA IN HASAN SADIKIN HOSPITAL; WHAT WE CAN LEARN FROM THE OUTBREAK
Natasha Ediwan,Anggarini Alam
Hasan Sadikin General Hospital
Background : Diphtheria was one of the leading causes of childhood death until the vaccine was invented. In November 2017 the government declared a status of diphtheria outbreak for 8 provinces, including West Java. RS Hasan Sadikin (RSHS) is the referral center in West Java. The study aims to describe the characteristics of patients with initial diagnosis of diphtheria hospitalized in RSHS from 1st January 2017 – 31st March 2018 and how many of them has the final diagnosis of probable or confirmed diphtheria.
Material : The study is cross-sectional and reports the characteristics of suspected pediatric diphtheria patients hospitalized in RSHS during the period of January 2017 – March 2018. All patients < 18 years old initially diagnosed with diphtheria are included. Data were taken from medical records retrospectively.
Results : 52 patients were initially diagnosed with diphtheria, of which 53.2% were male, with mean age 7.8 years old. The average cases from January – November 2017 were 1-2 cases/month, while on December there were 21 cases (40%; 76% had final diagnosis of non diphtheria), 9 cases in January, 14 cases in February, and 2 cases in March 2018. Demographically 52.9% came from Bandung city. Of 52 patients, 1 patient had positive culture for C. Diphtheria and diagnosed with confirmed diphtheria. The final diagnosis were 34.7% probable diphtheria, 7.8% suspect diphtheria, and 56.2% non diphtheria. All of the patients got antibiotic either orally, IV, IM or combined and 11.8% got ADS. There were 3 death cases all of which were diagnosed with probable diphtheria.
Conclusions : There was an increased of hospitalized cases of suspected diphtheria after the outbreak declaration, most of which were finally diagnosed as non-diphtheria. This phenomenon shows hysteria in the society. As health care worker we need a better understanding of characteristic diphtheria cases and clearly a better referral system.
Keywords: diphtheria outbreak characteristic
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