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Shigellosis in children: a clinico-epidemiological comparison between Shigella dysenteriae type I and Shigella

A S Faruque1, T Teka, G J Fuchs

  • 1International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh. gfaruque@icddrb.org

Annals of Tropical Paediatrics
|January 30, 1999
PubMed

Insights

Shigella dysenteriae type I infection in children is linked to older age, malnutrition, and poor sanitation. Shigella flexneri causes milder diarrhea, highlighting the need for hygiene interventions against shigellosis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Shigellosis is a significant cause of childhood diarrhea, particularly in developing countries.
  • Different Shigella species exhibit distinct clinical and epidemiological profiles.
  • Understanding these differences is crucial for targeted public health interventions.

Purpose of the Study:

  • To compare the clinical and epidemiological features of Shigella dysenteriae type I and Shigella flexneri infections in young children.
  • To identify host, behavioral, and environmental factors associated with each Shigella type.

Main Methods:

  • Retrospective review of 390 children under 5 years old treated for shigellosis between 1993-1995 in Dhaka, Bangladesh.
  • Analysis of clinical data, including stool consistency and duration of illness.
  • Assessment of host factors (age, nutritional status) and environmental/behavioral factors (water source, sanitation, antibiotic use).

Main Results:

  • Shigella dysenteriae type I infection was associated with older age (≥24 months), underweight, and wasting.
  • Factors like home antibiotic use, tubewell/pipe water, and poor sanitation were linked to S. dysenteriae type I.
  • S. flexneri infections presented with more watery stools and shorter illness duration (less than 4 days).

Conclusions:

  • Shigella dysenteriae type I infection is associated with more severe clinical manifestations and specific risk factors compared to S. flexneri.
  • Interventions targeting malnutrition and environmental hygiene are predicted to be more effective against S. dysenteriae than S. flexneri shigellosis.

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