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Epidemiological study of diphtheria in tananarive malagasy republic from 1960 to 1973 evolution of the endemic in time and space present regression causes and consequences

, : Epidemiological study of diphtheria in tananarive malagasy republic from 1960 to 1973 evolution of the endemic in time and space present regression causes and consequences. Archives de l'Institut Pasteur de Madagascar 44(1): 167-208

There was a sudden drop in endemic diphtheria morbidity in 1967 and of mortality in 1968, but an increase in the percentage of deaths after 1967. Since too few vaccinations were performed, the decline of the epidemic was not due to vaccinations. After the epidemic of 1966, a large proportion of the population apparently acquired a natural immunity, resulting in a lowered distribution of the diphtheria organism and lessened morbidity. The distribution of cases by areas reveals a disappearnace of diphtheria in residential neighborhoods and its persistance in densely populated areas. Where diphtheria incidence is highest, the disease is most severe. The maximal number of cases occurrs in the hot and humid season (Jan.-March). Improvements in endemic surveillance and control efforts are proposed. Education, vaccination, improved data collection, identification of carriers, and study of toxicity and virulence of existing strains are recommended.

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