Risk Factors Associated with Diphtheria Outbreak Among Patients Under 5 Years Attending de Martino Hospital Mogadishu, Somalia

<i>Background:</i> In areas with poor vaccination rates, diphtheria, a dangerous acute infectious disease brought on by Corynebacterium diphtheria, remains a threat. Due to low vaccination uptake and undeveloped immunity, children under five are especially at risk. <i>Objective:</i> risk factors and describing the clinical characteristics of diphtheria in children under five who were enrolled in De Martino Hospital in Mogadishu were the objectives of this study. <i>Methods:</i> Eighty confirmed cases of diphtheria participated in a descriptive cross-sectional investigation. Structured questionnaires and a review of medical records were used to gather data. Age, gender, immunization status, clinical characteristics, complications, and results were among the variables evaluated. <i>Findings:</i> Of the 80 children, 43.8% were younger than two years old, and 35.0% were between three and four years old. With 50.0% of the population being female and 48.8% being male, the gender distribution was almost equal. Only 15.0% of people were fully vaccinated, 21.3% were partially vaccinated, and 63.8% were not immunized. The two most common symptoms were fever (100%) and sore throat (100%). The following conditions were also quite common: dysphagia (93.8%), respiratory distress (98.8%), cervical lymphadenopathy (96.3%), and pseudo membrane development (98.8%). 25% of patients had myocarditis, and 75% of patients experienced respiratory problems. Residence of the patients (45.0%) resided in Yaqshid, followed by 16.3% from Karaan and 8.8% from Shibis. Smaller proportions of patients came from Dharkenley (6.3%), Celasha Biyaha (5.0%), Deynile (3.8%), Hodan (3.8%), and other areas including Kaxda, Hilwa, Sh. Dhexe, Hirshabele, Balcad, and Tabelaha, each contributing 2.5% to 1.3% of cases. This distribution indicates that Yaqshiid and Karaan were the most affected areas, suggesting a potential geographic clustering of cases., 76.3% recovered from the disease, while 23.8% did not. 77.5% was survived, while 22.5% was died, children who were not vaccinated having a higher death rate. Conclusion: diphtheria is still a serious public health issue in Somalia affecting children under five. The most frequent clinical symptoms were fever, sore throat, and pseudo membrane formation, while the main risk factors were found to be incomplete immunization, malnutrition, and delayed healthcare-seeking behavior. Improved immunization campaigns, early diagnosis, and prompt treatment treatments are critically needed, as highlighted by the high case fatality rate.