{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T14:02:43Z","timestamp":1776348163403,"version":"3.51.2"},"reference-count":33,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Introduction<\/jats:bold>\n                    : Diphtheria is a severe airborne bacterial anthroponosis characterized by high mortality rates and high prevalence in many geographical regions. It presents with a distinctive appearance in the oral cavity, marked by extensive pseudomembranes, and dentists may frequently be the first healthcare providers to diagnose it.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : The objective of our study was to assess dental practitioners\u2019 awareness of the distinct oral manifestations of diphtheria and the necessary anti-epidemic measures to implement before and during dental treatment of a patient with a suspected infection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and methods<\/jats:bold>\n                    : An anonymous survey of 367 dental practitioners was conducted from March to August 2025 using a questionnaire designed specifically for the study and containing 12 closed questions.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : A significant proportion of respondents (51.5%, n=189) assessed themselves as \u201cpartially familiar.\u201d Just 36.0% (n=132) of them thought they could spread the infection to other patients by using\n                    <jats:italic>Corynebacterium diphtheriae<\/jats:italic>\n                    -contaminated tools, surfaces, and equipment. The remainder have shown a lack of awareness of the potential modes of transmission within the dental practice. A considerable percentage of the surveyed dentists indicated their awareness of the necessary actions to take in the event of a suspected diphtheria patient (51.0%, n=187), while 49.0% (n=180) reported feeling partially prepared.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : The general theoretical ignorance among dental professionals of the epidemiological factors, transmission mechanisms, and typical oral manifestations of diphtheria is likely to result in a failure to implement all necessary precautions to prevent its spread in their clinical practice.\n                  <\/jats:p>","DOI":"10.3897\/folmed.68.e171679","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:12:40Z","timestamp":1776345160000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessment of dentists\u2019 knowledge of oral manifestations of Corynebacterium diphtheriae infection: a questionnaire-based survey"],"prefix":"10.3897","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8220-2292","authenticated-orcid":true,"given":"Veselina","family":"Kondeva","sequence":"first","affiliation":[{"name":"Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-4418","authenticated-orcid":true,"given":"Velina","family":"Stoeva","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5160-6323","authenticated-orcid":true,"given":"Rumyana","family":"Stoyanova","sequence":"additional","affiliation":[{"name":"Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"171679_B1","unstructured":"Murphy JR. Corynebacterium diphtheriae. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 32. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK7971\/."},{"key":"171679_B2","unstructured":"Ryan MJ, Ray CG. Sherris medical microbiology. 7th ed. New York: McGraw-Hill; 2021. Chapter 34: Corynebacterium species. Available from: https:\/\/www.scribd.com\/document\/245750366\/Aging"},{"key":"171679_B3"},{"key":"171679_B4"},{"key":"171679_B5","unstructured":"European Centre for Disease Prevention and Control (ECDC). Annual Epidemiological Report for Diphtheria-2022. Stockholm: ECDC;2023. Available from: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/diphtheria-annual-epidemiological-report-2022"},{"key":"171679_B6"},{"key":"171679_B7"},{"key":"171679_B8"},{"key":"171679_B9","unstructured":"WHO. Diphtheria. Fact sheet. 12 July 2024. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diphtheria"},{"key":"171679_B10"},{"key":"171679_B11","unstructured":"World Health Organization. Vaccine-preventable disease update: reported diphtheria cases in the WHO European Region, 2022: 19 January 2023. World Health Organization. Regional Office for Europe; 2023. Available from: https:\/\/www.who.int\/europe\/publications\/i\/item\/WHO-EURO-2023-6208-45973-68002"},{"key":"171679_B12","unstructured":"World Health Organization. Diphtheria, tetanus toxoid and pertussis (DTP) vaccination coverage [Internet]. 2024. Available from: https:\/\/immunizationdata.who.int\/global\/wiise-detail-page\/diphtheria-tetanus-toxoid-and-pertussis-(dtp)-vaccination-coverage"},{"key":"171679_B13"},{"key":"171679_B14","unstructured":"Centers for Disease Control and Prevention. Diphtheria. About Diphtheria. Accessed June 13, 2024. Available from: https:\/\/www.cdc.gov\/diphtheria\/index.html"},{"key":"171679_B15"},{"key":"171679_B16","unstructured":"Centers for Disease Control and Prevention (CDC). Update: diphtheria epidemic--New Independent States of the Former Soviet Union, January 1995-March 1996. MMWR Morb Mortal Wkly Rep 1996; 45(32):693\u20137. PMID: 8772204."},{"key":"171679_B17","unstructured":"PAHO. Diphtheria epidemiological report for the Americas. Washington DC: Pan American Health Organization; 2023. Available from: https:\/\/ghdx.healthdata.org\/organizations\/pan-american-health-organization-paho"},{"key":"171679_B18","doi-asserted-by":"crossref","unstructured":"Suligavi SS, Vishwanath DK, Gokale S, et al. Diphtheria: a re-emerging infectious disease. Int J Otorhinolaryngol Head Neck Surg [Internet]. 2021; 7(3):475\u201380. Available from: https:\/\/www.ijorl.com\/index.php\/ijorl\/article\/view\/27626","DOI":"10.18203\/issn.2454-5929.ijohns20210681"},{"key":"171679_B19"},{"key":"171679_B20","unstructured":"Nikolaeva N, Astaf\u2019eva N, Barer G, et al. [Diphtheria of the oral mucosa]. Stomatologiia (Mosk) 1995; 74(1):26\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/7770873\/ [Russian]."},{"key":"171679_B21"},{"key":"171679_B22"},{"key":"171679_B23"},{"key":"171679_B24"},{"key":"171679_B25","unstructured":"UNICEF Bulgaria. Childhood immunizations in Europe and Central Asia remain below critical levels while some countries record new declines. Sofia: UNICEF; 2024 Apr 24. Available from: https:\/\/www.unicef.org\/bulgaria\/en\/press-releases\/childhood-immunizations-europe-and-central-asia-remain-below-critical-levels-while"},{"key":"171679_B26","unstructured":"World Health Organization (WHO). DTP3 immunization coverage among 1-year-olds (%). Geneva, 19 Aug 2025. Available from: https:\/\/data.who.int\/indicators\/i\/48D7D19\/F8E084C"},{"key":"171679_B27","unstructured":"UNICEF. Immunization \u2013 data for every child. New York: UNICEF; July 2025 Available from: https:\/\/data.unicef.org\/topic\/child-health\/immunization\/."},{"key":"171679_B28","unstructured":"Sriparna R. Global childhood vaccination shows slight improvement but challenges remain, London: Reuters; 15 Jul 2025. Available from: https:\/\/www.reuters.com\/business\/healthcare-pharmaceuticals\/global-childhood-vaccination-shows-slight-improvement-challenges-remain-2025-07-15"},{"key":"171679_B29","unstructured":"Gregory A. Global vaccine rates for children fall in many high-income countries \u2013 study. London: The Guardian; 25 Jun 2025. Available from: https:\/\/www.theguardian.com\/society\/2025\/jun\/24\/children-global-vaccine-rates-fall-study finds"},{"key":"171679_B30","unstructured":"AP News. Global childhood vaccination shows small recovery, but 14 million children remain without any shots. New York: Associated Press; 15 Jul 2025. Available from: https:\/\/apnews.com\/article\/02aa5d5296e8609f5004f88950af3a0c"},{"key":"171679_B31","unstructured":"ECDC. Epidemiological update: Diphtheria cases in Europe. Available from: https:\/\/www.ecdc.europa.eu\/en\/news-events\/epidemiological-update-diphtheria-cases-europe"},{"key":"171679_B32","unstructured":"Ministry of Health, Republic of Bulgaria. [Immunization calendar 2025]. Sofia 2025. Available from: https:\/\/www.vaksinite.com\/wp-content\/uploads\/2025\/05\/imunizatsionen-kalendar-2025.pdf [Bulgarian]."},{"key":"171679_B33","doi-asserted-by":"crossref","unstructured":"Jones C. Routine vaccination coverage, 2023, Centers for Disease Control and Prevention (CDC), MMWR Morb Mortal Wkly Rep 2024; 73(43):978\u201384. Available from: https:\/\/www.cdc.gov\/mmwr\/volumes\/73\/wr\/mm7343a4.htm","DOI":"10.15585\/mmwr.mm7343a4"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/171679\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/171679\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=171679&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:12:55Z","timestamp":1776345175000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/171679\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,16]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.68.e171679","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,16]]},"article-number":"e171679"}}