{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:03:59Z","timestamp":1787018639833,"version":"build-2736575974"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T00:00:00Z","timestamp":1547251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Diphtheria, a vaccine preventable disease in children, is still being reported from India. Details of 99 children with a clinical diagnosis of diphtheria admitted to a paediatric tertiary care teaching and referral hospital between January 2008 and December 2015 were collected retrospectively and analysed. The median (interquartile range [IQR]) age of the study group was 7.0 years (IQR\u2009=\u20095.0\u20138.0 years). Nearly two-thirds were unimmunised. Clinical features included fever (97%), dysphagia (82%), sore throat (67%), bull neck (54%), stridor (40%), neuropathy (27%) and nasal discharge (14%). Throat swab for Albert stain was positive in only 21% of cases and C. diphtheriae was isolated in only 28%. Complications included airway compromise (61.7%) followed by myocarditis (35.4%), acute kidney injury (22.3%), thrombocytopenia (25.3%) and neuropathy (27.3%). In all, 66% survived, 23% died and 11% opted for discontinuity of care owing to unfavourable prognoses. On multivariable logistic regression analysis, shorter duration of symptoms before presentation to our hospital was an independent predictor of unfavourable outcome (adjusted odds ratio\u2009=\u20090.88, 95% confidence interval\u2009=\u20090.79\u20130.99, P\u2009=\u20090.03).<\/jats:p>","DOI":"10.1177\/0049475518823657","type":"journal-article","created":{"date-parts":[[2019,1,12]],"date-time":"2019-01-12T08:46:52Z","timestamp":1547282812000},"page":"96-101","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Clinico-epidemiological profile and predictors of outcome in children with diphtheria: a study from northern India"],"prefix":"10.1177","volume":"49","author":[{"given":"Nabaneeta","family":"Dash","sequence":"first","affiliation":[{"name":"Senior Resident, Department of Pediatrics, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5064-2325","authenticated-orcid":false,"given":"Sanjay","family":"Verma","sequence":"additional","affiliation":[{"name":"Professor, Department of Pediatrics, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Professor, Department of Pediatrics (Emergency and Critical Care), PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Professor, Department of Pediatrics, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj C","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Professor, Department of Pediatrics, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meenu","family":"Singh","sequence":"additional","affiliation":[{"name":"Professor, Department of Pediatrics (Emergency and Critical Care), PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,1,12]]},"reference":[{"key":"bibr1-0049475518823657","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.053819"},{"key":"bibr2-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305693"},{"key":"bibr3-0049475518823657","doi-asserted-by":"publisher","DOI":"10.3201\/eid1407.071167"},{"key":"bibr4-0049475518823657","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0218.69282"},{"key":"bibr5-0049475518823657","volume":"50","author":"Shaffi M","year":"2015","journal-title":"Econ Polit Wkly"},{"key":"bibr6-0049475518823657","first-page":"60","volume":"3","author":"Basavaraja GV","year":"2016","journal-title":"Int J Contemp Pediatr"},{"key":"bibr7-0049475518823657","first-page":"616","volume":"127","author":"Dravid MN","year":"2008","journal-title":"Indian J Med Res"},{"key":"bibr8-0049475518823657","first-page":"155","volume":"43","author":"Jayashree M","year":"2006","journal-title":"Indian Pediatr"},{"key":"bibr9-0049475518823657","volume-title":"WHO recommended surveillance standards","author":"World Health Organization","year":"1999","edition":"2"},{"key":"bibr10-0049475518823657","volume-title":"Rogers\u2019 Textbook of Pediatric Intensive Care","author":"Singhi SC","year":"2016"},{"key":"bibr11-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2012.11.005"},{"key":"bibr12-0049475518823657","unstructured":"Ministry of Women and Child Development Government of India.\n                      Rapid survey on Children (RSOC) 2013\u20132014. Fact sheet: India\n                      . Available at: http:\/\/wcd.nic.in\/sites\/default\/files\/State%20RSOC.pdf (accessed on 15 March 2018)."},{"key":"bibr13-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(34)80043-1"},{"key":"bibr14-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.2000.11748136"},{"key":"bibr15-0049475518823657","doi-asserted-by":"publisher","DOI":"10.4103\/1755-6783.102031"},{"issue":"1","key":"bibr16-0049475518823657","doi-asserted-by":"crossref","DOI":"10.4103\/0974-2069.149511","volume":"6","author":"Varghese MJ","year":"2013","journal-title":"Ann Pediatr Cardiol"},{"key":"bibr17-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1086\/344176"},{"key":"bibr18-0049475518823657","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2013.10.017"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475518823657","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0049475518823657","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475518823657","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:31:25Z","timestamp":1777642285000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0049475518823657"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,12]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1177\/0049475518823657"],"URL":"https:\/\/doi.org\/10.1177\/0049475518823657","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,12]]}}}