Keita A. K. auteur aut IRD Soumah A. K. auteur aut IRD Gnimadi T. A. C. auteur aut IRD Kande A. auteur aut IRD Kadio Kjjo auteur aut IRD Diallo H. auteur aut IRD Cisse M. auteur aut IRD Koivogui J. B. auteur aut IRD Kaba D. auteur aut IRD Bangoura S. T. auteur aut IRD Toure A. auteur aut IRD Fenollar F. auteur aut IRD Mediannikov Oleg auteur aut IRD Keita A. K. auteur aut IRD text journalArticle eng text/pdf reformatted digital access Background. This study presented the key characteristics of patients who tested positive for diphtheria during the outbreak in the Republic of Guinea in 2023 and assessed the influence of some risk factors on disease development. Methods. The clinical diagnosis of diphtheria was confirmed by detecting diphtheria toxin genes in nasopharyngeal samples collected from suspected patients via 2 reverse transcription-quantitative polymerase chain reaction tests. Bivariate analyses with the chi(2) test and the Fisher's exact test were conducted to explore possible associations between diphtheria positivity and various sociodemographic, clinical, and exposure factors. Results. In total, 444 samples obtained from suspected cases were analyzed. In 90 (20.3%) cases, the condition was confirmed using quantitative polymerase chain reaction, with an overall fatality rate of 8.9% (n = 8). On average, deaths occurred 2 days after admission, with 6 (75.0%) of 8 (6 girls and 2 boys) deaths recorded within the first 3 months after the epidemic onset. The clinical characteristics included sore throat (91%), fever (90%), whitish throat membrane (83%), throat redness (81%), and dyspnea (28%). The risk factors were age <15 years, no prior vaccination, and contact with a patient with diphtheria. A whitish throat membrane and dyspnea were significantly associated with diphtheria positivity. Conclusions. This study emphasized that diphtheria remains a major and potentially fatal disease, despite vaccination and early symptom recognition. The identification of characteristic signs-particularly a whitish throat membrane and dyspnea-is important for reducing disease severity and mortality. specialized epidemic surveillance in Guinea re-emergence of diphtheria vaccine-preventable disease GUINEE 050 052 084 12 9 ofaf527 [7 ] 2025 2328-8957 https://www.documentation.ird.fr/hor/fdi:010095300 10.1093/ofid/ofaf527 2328-8957 [F B010095300] https://www.documentation.ird.fr/hor/fdi:010095300 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-11/010095300.pdf IRD - Base Horizon / Pleins textes 2025-11-18 2026-03-24 fdi:010095300 fre