Shigella Diarrhoea in Six Asian Countries
Author Information
Author(s): von Seidlein Lorenz, Kim Deok Ryun, Ali Mohammad, Lee Hyejon, Wang XuanYi, Thiem Vu Dinh, Canh Do Gia, Chaicumpa Wanpen, Agtini Magdarina D, Hossain Anowar, Bhutta Zulfiqar A, Mason Carl, Sethabutr Ornthipa, Talukder Kaisar, Nair G. B, Deen Jacqueline L, Kotloff Karen, Clemens John
Primary Institution: International Vaccine Institute, Seoul, Korea
Hypothesis
What is the current disease burden, clinical manifestations, and microbiology of shigellosis in Asia?
Conclusion
Shigella is more common in impoverished Asian populations than previously thought, with emerging antibiotic-resistant strains.
Supporting Evidence
- Shigella was isolated from 2,927 (5%) of 56,958 diarrhoea episodes detected.
- The overall incidence of treated shigellosis was 2.1 episodes per 1,000 residents per year.
- Shigellosis incidence increased after age 40 years.
- S. flexneri was the most frequently isolated species in all sites except Thailand.
- High levels of antibiotic resistance were found among Shigella isolates.
Takeaway
Shigella causes a lot of diarrhea in poor countries, and some of the germs are getting stronger and harder to treat.
Methodology
A prospective, population-based study conducted in six Asian countries with standardized epidemiologic, clinical, and laboratory methods.
Potential Biases
Potential bias due to reliance on passive surveillance and cultural differences in healthcare-seeking behavior.
Limitations
The study relied on healthcare-seeking behavior, which may have led to underreporting of cases.
Participant Demographics
Participants included individuals of all ages from urban slums and rural areas in Bangladesh, China, Pakistan, Indonesia, Vietnam, and Thailand.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI, 45%–60%
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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