Skip to main content

Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon.

Publication ,  Journal Article
Kosek, M; Yori, PP; Pan, WK; Olortegui, MP; Gilman, RH; Perez, J; Chavez, CB; Sanchez, GM; Burga, R; Hall, E
Published in: Pediatrics
September 2008

Our goal was to estimate the impact of a Shigella vaccine in an area where shigellosis is endemic by characterizing the disease burden and antibiotic-resistance profiles of isolates and by determining the prevalence of Shigella flexneri serotypes.We conducted a 43-month-long prospective, community-based diarrheal disease surveillance in 442 children <72 months of age in the Peruvian Amazon between October 1, 2002, and April 15, 2006.The incidence of diarrheal disease was 4.38 episodes per child-year. The incidence rate for shigellosis was 0.34 episodes per child-year in children <72 months of age and peaked in children between 12 and 23 months at 0.43 episodes per child-year. Maternal education at or beyond the primary grade level, piped water supply, weight-for-age z score, and improved water-storage practices were the most significant determinants of disease in this community with living conditions comparable to many rural areas in the developing world.Children living in this region had a 20-fold higher rate of disease incidence detected by active surveillance as those recently estimated by passive detection. Most symptomatic disease was caused by S flexneri, although the diversity of serotypes will require a multivalent vaccine to have a significant impact on the burden of disease caused by shigellosis. Several other public health disease-control interventions targeted at water source and improved storage, nutritional interventions, and improved maternal education seem to have a greater impact than a univalent S flexneri 2a vaccine.

Duke Scholars

Published In

Pediatrics

DOI

EISSN

1098-4275

ISSN

0031-4005

Publication Date

September 2008

Volume

122

Issue

3

Start / End Page

e541 / e549

Related Subject Headings

  • Socioeconomic Factors
  • Shigella flexneri
  • Rural Population
  • Risk Factors
  • Prospective Studies
  • Polymerase Chain Reaction
  • Peru
  • Pediatrics
  • Male
  • Infant, Newborn
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kosek, M., Yori, P. P., Pan, W. K., Olortegui, M. P., Gilman, R. H., Perez, J., … Hall, E. (2008). Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon. Pediatrics, 122(3), e541–e549. https://doi.org/10.1542/peds.2008-0458
Kosek, Margaret, Pablo Peñataro Yori, William K. Pan, Maribel Paredes Olortegui, Robert H. Gilman, Juan Perez, Cesar Banda Chavez, Graciela Meza Sanchez, Rosa Burga, and Eric Hall. “Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon.Pediatrics 122, no. 3 (September 2008): e541–49. https://doi.org/10.1542/peds.2008-0458.
Kosek M, Yori PP, Pan WK, Olortegui MP, Gilman RH, Perez J, et al. Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon. Pediatrics. 2008 Sep;122(3):e541–9.
Kosek, Margaret, et al. “Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon.Pediatrics, vol. 122, no. 3, Sept. 2008, pp. e541–49. Epmc, doi:10.1542/peds.2008-0458.
Kosek M, Yori PP, Pan WK, Olortegui MP, Gilman RH, Perez J, Chavez CB, Sanchez GM, Burga R, Hall E. Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon. Pediatrics. 2008 Sep;122(3):e541–e549.

Published In

Pediatrics

DOI

EISSN

1098-4275

ISSN

0031-4005

Publication Date

September 2008

Volume

122

Issue

3

Start / End Page

e541 / e549

Related Subject Headings

  • Socioeconomic Factors
  • Shigella flexneri
  • Rural Population
  • Risk Factors
  • Prospective Studies
  • Polymerase Chain Reaction
  • Peru
  • Pediatrics
  • Male
  • Infant, Newborn