Epidemiology of shigellosis among children exposed to cases of Shigella dysentery : A mutivariate assessment.
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 (OR=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 I infections than in S. flexneri infections (OR=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). (...)
Mots-clés Pascal : Shigellose, Bactériose, Infection, Shigella flexneri, Enterobacteriaceae, Bactérie, Shigella dysenteriae, Epidémiologie, Enfant, Homme, Bengla Desh, Asie, Diarrhée, Facteur risque, Appareil digestif pathologie, Intestin pathologie
Mots-clés Pascal anglais : Shigellosis, Bacteriosis, Infection, Shigella flexneri, Enterobacteriaceae, Bacteria, Shigella dysenteriae, Epidemiology, Child, Human, Bangladesh, Asia, Diarrhea, Risk factor, Digestive diseases, Intestinal disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0281641
Code Inist : 002B05B02F. Création : 15/07/1997.