Open AccessJournal Article
Global Burden of Shigella Infections: Implications for Vaccine Development and Implementation of Control Strategies
Karen L. Kotloff,Jonathan P. Winickoff,Bernard Ivanoff,John D. Clemens,David L. Swerdlow,Philippe J. Sansonetti,Goutam K. Adak,Myron M. Levine +7 more
TLDR
Shigellosis, which continues to have an important global impact, cannot be adequately controlled with the existing prevention and treatment measures, and innovative strategies, including development of vaccines against the most common serotypes, could provide substantial benefits.Abstract:
Few studies provide data on the global morbidity and mortality caused by infection with Shigella spp.; such estimates are needed, however, to plan strategies of prevention and treatment. Here we report the results of a review of the literature published between 1966 and 1997 on Shigella infection. The data obtained permit calculation of the number of cases of Shigella infection and the associated mortality occurring worldwide each year, by age, and (as a proxy for disease severity) by clinical category, i.e. mild cases remaining at home, moderate cases requiring outpatient care, and severe cases demanding hospitalization. A sensitivity analysis was performed to estimate the high and low range of morbid and fatal cases in each category. Finally, the frequency distribution of Shigella infection, by serogroup and serotype and by region of the world, was determined. The annual number of Shigella episodes throughout the world was estimated to be 164.7 million, of which 163.2 million were in developing countries (with 1.1 million deaths) and 1.5 million in industrialized countries. A total of 69% of all episodes and 61% of all deaths attributable to shigellosis involved children under 5 years of age. The median percentages of isolates of S. flexneri, S. sonnei, S. boydii, and S. dysenteriae were, respectively, 60%, 15%, 6%, and 6% (30% of S. dysenteriae cases were type 1) in developing countries; and 16%, 77%, 2%, and 1% in industrialized countries. In developing countries, the predominant serotype of S. flexneri is 2a, followed by 1b, 3a, 4a, and 6. In industrialized countries, most isolates are S. flexneri 2a or other unspecified type 2 strains. Shigellosis, which continues to have an important global impact, cannot be adequately controlled with the existing prevention and treatment measures. Innovative strategies, including development of vaccines against the most common serotypes, could provide substantial benefits.read more
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Journal Article
The magnitude of the global problem of diarrhoeal disease: a ten-year update.
TL;DR: This paper carried out a review of articles published from 1980 to the present and calculated median estimates for the incidence of diarrhoea and diarrhoeal mortality among under-5-year-olds.
Journal ArticleDOI
Epidemiology of Travelers' Diarrhea and Relative Importance of Various Pathogens
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