Few studies also indicate low diphtheria immunity among school-going children and adults. Information about coverage of diphtheria boosters is not routinely collected through these surveys, but is expected to be low. As per the national level health surveys, coverage of three doses of diphtheria vaccine was 80% during 2015-2016. In some Indian states, Muslim children are affected more. Hospital-based surveillance studies as well as diphtheria outbreaks published in last 20 years (1996-2016) indicate that diphtheria cases are frequent among school-going children and adolescents. A substantial proportion of global burden of diphtheria is contributed by India. Globally, diphtheria has been showing a declining trend due to effective childhood vaccination programs. Diphtheria is an acute disease caused by exotoxin-producing Corynebacterium diphtheriae.
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