Diphtheria diagnostic capacity in the Western Pacific Region
PHE ePoster Library. Trindall A. Apr 9, 2019; 259612; 15589
Amy Trindall
Amy Trindall
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Abstract Background

Diphtheria is uncommon in many countries but when cases arise they are often severe with high mortality. This disease has demonstrated its potential to re-emerge to epidemic proportions in areas where it was previously controlled. Ongoing microbiological and epidemiological surveillance is essential to ensure cases are identified and treated promptly. Maintaining diphtheria diagnostic expertise in spite of low prevalence is a key challenge for diphtheria surveillance.To assess diphtheria diagnostic capacity across laboratories in the WHO Western Pacific Region (WPR), a survey was undertaken by the WHO Global Collaborating Centre for Reference and Research on Diphtheria, with the WHO WPR regional office.


An electronic survey was adapted from the 2017 questionnaire used to assess diphtheria diagnostic capacity in the EU/EEA, and distributed to 18 laboratories in 15 countries. Responses were assessed for minimum standards in three areas: microbiological and epidemiological surveillance; laboratory diagnostic capacity; and expertise in laboratory diagnostics.


Responses were analysed for 15 laboratories (83%) in 12 countries (80%). All countries reported diphtheria was a notifiable disease, and had surveillance systems in place. One country did not report a close collaboration between microbiology and epidemiology for surveillance. Three countries reported partial diagnostic capacity and nine reported reference-level capacity based on the culture, biochemical identification and toxigenicity testing methods used. No laboratory staff attended comprehensive external training workshops in the last five years, and 73% felt that a training workshop was needed.


There are potentially significant gaps in diphtheria diagnostic capacity in the WPR, with only nine countries fulfilling minimum standards for surveillance and laboratory methods. The greatest gap related to training in building laboratory diagnostics expertise. The results of the survey demonstrate the need for countries to maintain both clinical and microbiological awareness of diphtheria to inform surveillance and outbreak management. Funding Funded by WHO WPRO
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