Journal ArticleDOI
Epidemiology of shigellosis among children exposed to cases of Shigella dysentery: a multivariate assessment.
Reads0
Chats0
TLDR
The findings show that the high risk of shigellosis in residentially exposed Bangladeshi children results from multiple Shigella strains circulating concurrently within the same neighborhood; demonstrate that the risk is notably modified by host age, nutritional status, and dietary patterns; and illustrate that the classic picture of dysentery is relatively infrequent and is correlated with the infecting species and with host nutritional status.Abstract:
We followed 1,756 young, rural Bangladeshi children less than five years of age for one month after identification of sentinel Shigella patients in their neighborhoods. Two hundred nineteen (12%) children developed Shigella diarrhea (shigellosis) and 227 (13%) developed culture-negative dysentery. Shigella flexneri (60%) and S. dysenteriae, type 1 (15%) were the most common isolates among shigellosis cases. Within individual neighborhoods, there was poor agreement (Kappa = 0.21) between Shigella species isolated from sentinel patients and from additional cases detected during surveillance. The risk of shigellosis increased substantially after infancy and peaked in the second year of life. Severe stunting, as assessed by height-for-age, was associated with an increased risk of shigellosis (adjusted odds ratio [ORa] = 1.67, 95% confidence interval [CI] = 1.09-2.57, P < 0.05), while breast-feeding was protectively associated (ORa = 0.40, 95% CI = 0.24-0.69, P < 0.001). Only 43% of the shigellosis cases reported bloody stools; frank dysentery occurred more frequently in S. dysenteriae 1 infections than in S. flexneri infections (ORa = 5.04, 95% CI = 1.76-14.48, P < 0.01), and was also associated with severe stunting (ORa = 2.16, 95% CI = 1.01-4.58, P < 0.05). Our findings show that the high risk of shigellosis in residentially exposed Bangladeshi children results from multiple Shigella strains circulating concurrently within the same neighborhood; demonstrate that the risk is notably modified by host age, nutritional status, and dietary patterns; and illustrate that the classic picture of dysentery is relatively infrequent and is correlated with the infecting species and with host nutritional status.read more
Citations
More filters
Journal ArticleDOI
Host defense benefits of breastfeeding for the infant. Effect of breastfeeding duration and exclusivity.
TL;DR: In this article, the evidence regarding the host defense benefits of breastfeeding for term infants of normal birth weight is reviewed, with an emphasis on recent information from industrialized countries regarding how the degree and duration of breastfeeding affect infant health.
Journal ArticleDOI
Epidemiology of sporadic bloody diarrhea in rural western kenya
John T. Brooks,Roger L. Shapiro,Lata Kumar,Joy G. Wells,Penelope A. Phillips-Howard,Ya-Ping Shi,John M. Vulule,Robert M. Hoekstra,Eric D. Mintz,Laurence Slutsker +9 more
TL;DR: Providing safe drinking water and more latrines, and promoting hand washing could reduce the burden of illness from bloody diarrhea while limiting injudicious antimicrobial use.
Journal ArticleDOI
Etiology of childhood diarrhea after rotavirus vaccine introduction: a prospective, population-based study in Nicaragua.
Sylvia Becker-Dreps,Filemon Bucardo,Samuel Vilchez,Luis Enrique Zambrana,Lan Liu,David J. Weber,Rodolfo Peña,Leslie Barclay,Jan Vinjé,Michael G. Hudgens,Johan Nordgren,Lennart Svensson,Douglas R. Morgan,Douglas R. Morgan,Felix Espinoza,Margarita Paniagua +15 more
TL;DR: In this Central American community after RV5 introduction, rotavirus was not commonly detected among children with diarrhea, and prevention and appropriate management of norovirus and sapovirus should be considered to further reduce the burden of diarrheal disease.
Journal ArticleDOI
Gastrointestinal and Extra-Intestinal Manifestations of Childhood Shigellosis in a Region Where All Four Species of Shigella Are Endemic
TL;DR: Both severe intestinal disease and extra-intestinal manifestations of shigellosis occur with infection by any of the four species of Shigella, but are most common with S. dysenteriae type 1.
Journal ArticleDOI
Part II. Analysis of data gaps pertaining to Shigella infections in low and medium human development index countries, 1984-2005.
TL;DR: The large gaps in data on the burden of Shigella infections for low human development index countries and, more specifically, for sub-Saharan Africa are highlighted.
Related Papers (5)
A multicentre study of Shigella diarrhoea in six Asian countries: disease burden, clinical manifestations, and microbiology.
Lorenz von Seidlein,Deok Ryun Kim,Mohammad Ali,Hyejon Lee,Xuan-Yi Wang,Xuan-Yi Wang,Vu Dinh Thiem,Do Gia Canh,Wanpen Chaicumpa,Magdarina D. Agtini,Anowar Hossain,Zulfiqar A Bhutta,Carl J. Mason,Ornthipa Sethabutr,Kaisar A. Talukder,Gopinath Balakrish Nair,Jacqueline L. Deen,Karen L. Kotloff,John D. Clemens +18 more