Nigeria’s 8,587 Diphtheria Cases, 884 Deaths Highest in Africa – WHO

Nigeria currently tops Africa in reported diphtheria cases, recording 8,587 confirmed infections and 884 deaths between January 1 and November 2, 2025, according to new data obtained from the World Health Organisation.

The WHO report shows that Nigeria continues to account for the highest burden of diphtheria in the region. It noted that the country recorded 12,150 suspected cases within the same period, spread across 240 Local Government Areas in 30 states. Only three per cent of confirmed cases were verified through laboratory testing, with most diagnosed clinically.

Médecins Sans Frontières (Doctors Without Borders) recently announced that it has expanded its diphtheria response in partnership with state ministries of health, following a significant rise in cases in Borno, Kano, and Bauchi. MSF said hundreds of suspected cases reported over the past three months have overwhelmed health facilities, exposing major gaps in treatment capacity and vaccination coverage.

Children and adolescents remain the most affected group, with the WHO warning that more than two million children in Nigeria are under-immunised or have received no vaccines at all. The agency highlighted that low vaccination coverage is fuelling transmission. Reactive vaccination campaigns have been carried out in Imo, Kaduna, and Lagos, but challenges persist, including vaccine shortages, weak infection control, delayed lab confirmation, and limited communication materials.

The WHO added that discussions are ongoing with Gavi, the Vaccine Alliance, to secure additional support. WHO/UNICEF immunisation estimates for 2024 show 71 per cent coverage for the first DTP dose and 67 per cent for the third.

Across Africa, several countries are also battling diphtheria outbreaks:

• Algeria recorded an outbreak in Skikda province in October 2025, reporting 13 suspected cases, eight confirmed, and two deaths, mainly among unvaccinated individuals.
• Chad reported 4,462 suspected cases and 47 deaths, with only four confirmed due to laboratory limitations.
• Guinea has documented 476 suspected cases and 123 deaths since June, with over 80 per cent occurring in Siguiri district.
• Mali confirmed 430 suspected cases and 29 deaths across seven regions, with rapid spread from three to 30 affected districts in six weeks.
• Mauritania recorded 849 suspected cases, 318 confirmed, and 33 deaths, with most cases among children and adolescents aged five to 19.
• Niger reported 1,926 suspected cases and 122 deaths, primarily in Agadez, Diffa, and Zinder.
• South Africa has reported 106 cases, including confirmed respiratory infections and asymptomatic carriers across five provinces, with the Western Cape most affected.

Between January 1 and November 2, 2025, the WHO African Region recorded 20,412 suspected diphtheria cases and 1,252 deaths across eight member states. Of these, 9,864 cases were confirmed through laboratory tests, clinical diagnosis, or epidemiological links. Women, children aged 5–18, and young adults under 30 remain the most affected, reflecting wide immunity gaps.

The WHO described the resurgence of diphtheria in multiple countries as a major public health concern, prompting its classification as a grade two emergency. Response efforts are being challenged by global shortages of diphtheria antitoxin and limited laboratory capacity.

The organisation stressed that effective control requires coordinated action involving case detection, surveillance, laboratory confirmation, clinical care, infection prevention, community engagement, and strong routine immunisation systems.