Consequences of Shigella infection in young children: a systematic review

Libby, Tanya; Al-Shimari, Fatima; MacLennan, Calman A.; Vannice, Kirsten; Pavlinac, Patricia B

doi:10.1016/j.ijid.2023.01.034

Cited by 14 publications

(10 citation statements)

References 80 publications

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“…In our study, Shigella was the most common bacteria detected accounting for nearly 47% of diarrhea in children above 2 years. Shigella infections not only pose immediate health risks, but also can have long-term effects, such as malnutrition and negative effects on physical and cognitive development [ 26 , 27 ]. For these reasons, burden of diarrhea is underestimated when only incidence and mortality is accounted for and the diarrheal associated Disability-Adjusted Life Years (DALYs) increased by about 40% when long term sequelae were also taken into consideration [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Etiology of diarrheal hospitalizations following rotavirus vaccine implementation and association of enteric pathogens with malnutrition among under-five children in India

Varghese,

Mills,

Revathi

et al. 2024

Gut Pathog

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Malnourished children are at higher risk of mortality and morbidity following diarrheal illness and certain enteropathogens have been associated with malnutrition in children. Very few studies have comprehensively looked at the etiology of diarrhea in malnourished children and most have used conventional diagnostic methods with suboptimal sensitivity. We used a highly sensitive molecular approach against a broad range of pathogens causing diarrhea and examined their association with malnutrition. In addition, we looked at the pathogen diversity of pediatric diarrhea, three years after the nationwide rotavirus vaccine introduction to understand the evolving landscape of pathogens, which is crucial for planning strategies to further reduce the diarrhea burden. Clinical details and diarrheal stool samples were collected from hospitalized children aged < 5 years from three sentinel sites in India for a period of one year. The samples were tested by qPCR for 16 established causes of diarrhea using TaqMan Array Cards. A total of 772 children were enrolled, from whom 482 (62.4%) stool specimens were tested. No specific pathogen was associated with diarrhea among children with acute or chronic malnutrition compared to those with better nutritional status. Overall, adenovirus was the leading pathogen (attributable fraction (AF) 16.9%; 95% CI 14.1 to 19.2) followed by rotavirus (AF 12.6%; 95% CI 11.8 to 13.1) and Shigella (AF 10.9%; 95% CI 8.4 to 16.4). The majority of diarrhea requiring hospitalization in children aged < 2 years could be attributed to viruses, while Shigella was the most common pathogen among children aged > 2 years. These data on the prevalence and epidemiology of enteropathogens identified potential pathogens for public health interventions.

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Section: Discussionmentioning

confidence: 99%

Etiology of diarrheal hospitalizations following rotavirus vaccine implementation and association of enteric pathogens with malnutrition among under-five children in India

Varghese,

Mills,

Revathi

et al. 2024

Gut Pathog

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“…Furthermore, studies have specifically linked Shigella -attributable moderate and severe diarrhoea in infants and toddlers with linear growth faltering as early as 2–3 months after the initial episode; in one study, linear growth faltering was documented to persist for at least 3 years post-infection. 16 , 21 Furthermore, children aged 12–24 months with confirmed shigellosis who were subsequently treated with antibiotics exhibited a fourfold decrease in linear growth faltering when compared to their untreated counterparts. 18…”

Section: Assessing the Valuementioning

confidence: 99%

Reassessing potential economic value and health impact of effective Shigella vaccines

Hausdorff,

Anderson,

Bourgeois

et al. 2024

Bull World Health Organ

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The gram-negative bacterium Shigella is a leading cause of diarrheal morbidity and mortality in children in low- and middle-income countries. Several promising vaccine candidates are in late stages of clinical development against this increasingly antibiotic-resistant pathogen. However, considering the increasingly crowded and costly paediatric immunization schedule, and likely advent of other important new vaccines, it is unclear whether introduction of a Shigella vaccine would represent a high priority for international agencies or health ministries in low- and middle-income countries. To determine whether there is a compelling public health value proposition for a Shigella vaccine, we used the World Health Organization’s Full Value of Vaccine Assessment analytic framework and formulated five broad scientific, policy, economic and commercial-related propositions regarding the development of a Shigella vaccine. We also explored the current regulatory, clinical, policy and commercial challenges to a Shigella -containing combination vaccine development and adoption. Through a series of literature reviews, expert consultations, social science field studies and model-based analyses, we addressed each of these propositions. As described in a series of separate publications that are synthesized here, we concluded that the economic and public health value of a Shigella vaccine may be greater than previously recognized, particularly if it is found to also be effective against less severe forms of diarrheal disease and childhood stunting. The decision by pharmaceutical companies to develop a standalone vaccine or a multipathogen combination will be a key factor in determining its relative prioritization by various stakeholders in low- and middle-income countries.

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“…Furthermore, the burden of Shigella extends beyond direct diarrhea-associated morbidity and mortality. Shigella is more likely than other diarrhea etiologies to cause persistent diarrhea, which is associated with stunting and wasting [ 9 ]. Stunting, defined as linear growth >2 SDs below the median, is associated with negative impacts on cognitive development, risk of subsequent disease, and long-term economic potential [ 10 ].…”

Section: Shigella Burdenmentioning

confidence: 99%

Optimizing Vaccine Trials for Enteric Diseases: The Enterics for Global Health (EFGH) Shigella Surveillance Study

Vannice,

MacLennan,

Long

et al. 2024

Open Forum Infectious Diseases

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In this introductory article, we describe the rationale for the Enterics for Global Health (EFGH) Shigella surveillance study, which is largely to optimize the design and implementation of pivotal Shigella vaccine trials in the target population of infants and young children living in low- and middle-income countries. Such optimization will ideally lead to a shorter time to vaccine availability in the target population. We also provide a brief description of the articles included in the supplement.

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Consequences of Shigella infection in young children: a systematic review

Cited by 14 publications

References 80 publications

Etiology of diarrheal hospitalizations following rotavirus vaccine implementation and association of enteric pathogens with malnutrition among under-five children in India

Etiology of diarrheal hospitalizations following rotavirus vaccine implementation and association of enteric pathogens with malnutrition among under-five children in India

Reassessing potential economic value and health impact of effective Shigella vaccines

Optimizing Vaccine Trials for Enteric Diseases: The Enterics for Global Health (EFGH) Shigella Surveillance Study

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