Shigella in Africa: New Insights From the Vaccine Impact on Diarrhea in Africa (VIDA) Study. (19th April 2023)

• Record Type: Journal Article
• Authors: Kasumba, Irene N; Badji, Henry; Powell, Helen; Hossain, M Jahangir; Omore, Richard; Sow, Samba O; Verani, Jennifer R; Platts-Mills, James A; Widdowson, Marc-Alain; Zaman, Syed M A; Jones, Jennifer; Sen, Sunil; Permala-Booth, Jasnehta; Nasrin, Shamima; Roose, Anna; Nasrin, Dilruba; Ochieng, John Benjamin; Juma, Jane; Doh, Sanogo; Jones, Joquina Chiquita M; Antonio, Martin; Awuor, Alex O; Sugerman, Ciara E; Watson, Nora; Focht, Christopher; Liu, Jie; Houpt, Eric; Kotloff, Karen L; Tennant, Sharon M
• Is Part Of: Clinical infectious diseases. Volume 76:(2023)Supplement 1
• Page Start: S66
• Page End: S76
• Publication Date: 2023-04-19
• Subjects: Shigella -- diarrhea -- Africa -- children -- dysentery; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac969
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: We evaluated the burden of Shigella spp from children aged 0–59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018. Methods: Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis. Results: The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S . flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%). Conclusions: A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin. Abstract : We evaluated the burden of Shigella spp from children 0–59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa study from 2015 to 2018.