Part II. Analysis of data gaps pertaining to Shigella infections in low and medium human development index countries, 1984-2005.
The global incidence of Shigella infection has been estimated at 80-165 million episodes annually, with 99% of episodes occurring in the developing world. To identify contemporary gaps in the understanding of the global epidemiology of shigellosis, we conducted a review of the English-language scientific literature from 1984 to 2005, restricting the search to low and medium human development countries. Our review yielded 11 population-based studies of Shigella burden from seven countries. No population-based studies have been conducted in sub-Saharan Africa or in low human development countries. In studies done in all age groups, Shigella incidence varied from 0.6 to 107 episodes/1000 person-years. S. flexneri was the most commonly detected subgroup in the majority of studies. Case-fatality rates ranged from 0% to 2.6% in population-based studies and from 0% to 21% in facility-based studies. This review highlights the large gaps in data on the burden of Shigella infections for low human development index countries and, more specifically, for sub-Saharan Africa.
Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA. pkram@buffalo.edu
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D003906:Developing Countries; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D012760:Shigella / Q000145:classification / Q000302:isolation & purification*