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By Arnold Ageta

When his seven-year-old brother Jubrin was diagnosed with diphtheria in July this year, Aminu Dayyabu Alharini had never heard of the disease. The latest outbreak of this disease claimed more than 500 lives in Nigeria.

When Jubrin was diagnosed with diptheria, he was immediately transferred from the health facility near their home in Alharini settlement, in Kano State, Nigeria, to a specialist hospital after he suddenly developed a high fever following two days of complaining of a sore throat.

Cumulatively from May 2022 to October 2023, 15 569 suspected (9772 confirmed) diphtheria cases that have been reported across Nigeria, 547 of whom have died. Confirmed cases have been recorded in 19 states, with the Federal Capital Territory (FCT), Kano, Yobe and Bauchi states the worst affected.

Kano state, where Jubrin lives, bears the highest burden of the disease, with 8022 confirmed cases. Diphtheria is highly contagious and can lead to severe respiratory complications due to the formation of a greyish membrane in the throat. If it goes without treatment, it obstructs breathing and can result in death.

Those who receive prompt treatment, like Jubrin, make full recovery. Following his recovery, Jubrin’s brother, a village head, is now using the experience and position in the community to raise awareness and educate people on the importance of childhood immunization against diseases such as diphtheria.

“Interrupting transmission in Kano state is crucial to reduce the risk of spread at the community level,” explains Dr Abubakar Labaran Yusuf, Kano State Commissioner of Health.

WHO is working with partners to support the government at national and subnational levels to strengthen the outbreak response. It has disbursed US$ 1.3 million for the response to enhance key outbreak control measures including disease surveillance, laboratory testing, contract tracing, case investigation and treatment, training as well as collaborating with communities to support the response efforts.

With support from various partners, Kano state successfully carried out three phases of reactive routine immunization campaigns between February and August this year using the combination tetanus-diphtheria and pentavalent vaccines. All three doses are necessary for full protection against diphtheria. WHO has also provided and helped the country procure medicines to treat the disease.

Almost 75 000 zero-dose children under the age of two received the first dose of the pentavalent vaccine, while around 670 000 eligible children (4‒14 years) were vaccinated with the tetanus-diphtheria vaccine in 18 high-burden local government areas in Kano state.

WHO is providing technical expertise and has developed guidelines and strategic documents for the federal government, states and partners, to ensure effective coordination.

“WHO is committed to work with the Government of Nigeria and partners to ensure that we respond swiftly and in a coordinated manner to this concerning outbreak of a vaccine-preventable disease,” says Dr Walter Kazadi Mulombo, WHO Representative in Nigeria. “We cannot stop until we have reached all children who have not been vaccinated against diphtheria and continue encouraging all parents to bring their children for routine childhood immunizations.”

Safiya Mohammed, a mother of two and a resident of Ungogo Local Government Area, a hotspot for diphtheria in Kano state, ensured her children were vaccinated.

“I had never heard of diphtheria,” Safiya says. “I don’t want my children or those in the neighbourhood to fall sick or die from the disease. To protect my children, I also need to make sure the children they play with are protected.”

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