Epidemiology of Sporadic Bloody Diarrhea in Rural Western Kenya

Brooks, John T.; Shapiro, Roger; Kumar, Lata; Wells, Joy G.; Phillips-Howard, Penelope A.; Shi, Yaping; Vulule, John; Hoekstra, Robert M.; Mintz, Eric D.; Slutsker, Laurence

doi:10.4269/ajtmh.2003.68.671

Cited by 61 publications

(64 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Resistance is also highly prevalent among all Shigella serovars from Sudan, Kenya, Nigeria and Ethiopia [129,131,160,161]. A class 2 integron bearing cassette encoding resistance to trimethoprim, streptomycin, and spectinomycin has been described in Sh.…”

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

“…Contaminated water and person-toperson transfer of these organisms are probably predominant routes for spread. Water supplies, sanitation and frequency of hand-washing with soap could be improved in most parts of Africa [260] and these interventions are proven to prevent the acquisition and spread of diarrheagenic E. coli and other pathogens [129,140,[261][262][263][264].…”

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

“…However, generation and dissemination of epidemiological data still falls short of need. Shigella flexneri is the serovariety that predominates in developing countries, including those in Africa, although virtually all serovars are recovered in medium to large studies [129][130][131][132]. Shigella remains an important etiologic agent of diarrheal disease in older children and adults [19].…”

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

See 2 more Smart Citations

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

120

103

View full text Add to dashboard Cite

Diarrhea is a leading cause of illness and death, particularly in developing countries. Enteropathogenic Escherichia coli, enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enterohemorrhaghic E. coli (EHEC), enteroaggregative E. coli (EAEC) and diffusely adherent E. coli (DAEC) have been associated with diarrheal disease in different parts of Africa, particularly among young children, HIV-positive individuals, and visitors from abroad. Each of these E. coli pathotypes uses distinct mechanisms, which are only partially understood, to colonize infected hosts and produce diarrhea. All known diarrheagenic E. coli pathotypes have been reported from diverse locations within Africa but the true burden from these pathogens is unknown because very few studies seeking these organisms with discriminatory methodology have been performed. Recent reports implicate ETEC and EAEC in a considerable proportion of childhood and travellers' diarrheas and suggest that some sub-types of these categories may have greater epidemiological significance than others. The significant contribution of EHEC to bloody diarrhea and hemolytic uremic syndrome is underappreciated because diagnostic capacity for this pathotype is generally inferior to that for confounders such as Shigella and Entamoeba. Recent studies in Africa have revealed the worrisome emergence of antimicrobial resistance and high asymptomatic carriage rates for diarrheagenic E. coli but bacterial and host factors that predispose to disease, as well as non-human reservoirs, are largely unknown. Future diarrheal disease research needs to focus on broadening the repertoire of pathogens sought in epidemiological surveys to include multiple categories of diarrheagenic E. coli while building capacity to detect these pathogens in local reference laboratories.

show abstract

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

Section: Clinically Relevant Unanswered Questions About the Biology Omentioning

confidence: 99%

Section: Enteroinvasive E Coli and Shigellamentioning

confidence: 99%

See 1 more Smart Citation

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Okeke

2009

J Infect Dev Ctries

120

103

View full text Add to dashboard Cite

show abstract

“…The distribution of Shigella species and Shigella flexneri serotypes from selected studies in Latin America, Asia and Africa. Several population-based surveillance studies lasting at least 2 years used extensive serotyping methods (including either commercial absorbed animal sera or monoclonal antibodies for Shigella flexneri typing) [6][7][8][9][129][130][131] . In all countries, S. flexneri 2a is the single most important S. flexneri subserotype.…”

Section: Shigella Vaccine Strategiesmentioning

confidence: 99%

Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road

et al. 2007

View full text Add to dashboard Cite

More than 50 years of research has yielded numerous Shigella vaccine candidates that have exemplified both the promise of vaccine-induced prevention of shigellosis and the impediments to developing a safe and effective vaccine for widespread use, a goal that has yet to be attained. This Review discusses the most advanced strategies for Shigella vaccine development, the immune responses that are elicited following disease or vaccination, the factors that have accelerated or impeded Shigella vaccine development and our ideas for the way forward.At the end of the 19th century, as epidemics of bacillary dysentery accompanied by high mortality spread across Japan, the young microbiologist Kiyoshi Shiga examined dysenteric stools and isolated a bacterium that was agglutinated by serum from convalescent patients but not from patients with acute disease [1][2][3] (FIG. 1). That bacterium -known today as Shigella dysenteriae 1 -was the first identified member of the genus Shigella. Four Correspondence to M.L. mlevine@medicine.umaryland.edu. Competing interests statement:The authors declare no competing financial interests. Links NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptShigella species (or groups) are now recognized: S. dysenteriae (group A), which has 15 serotypes; Shigella flexneri (group B), which has 14 classical serotypes and subserotypes; Shigella boydii (group C), which has 20 serotypes; and Shigella sonnei (group D), which has single serotype 4 (TABLE 1).There has been resurgent interest in Shigella as a human pathogen, driven by the availability of more precise data on the disease burden 5-8 , emerging antibiotic resistance 9,10 and the fact that mucosally invasive Shigella, which often cause dysentery (gross blood in diarrhoeal stools), are less amenable to the salutary effects of oral rehydration than non-invasive pathogens that cause watery diarrhoea, such as Vibrio cholerae and enterotoxigenic Escherichia coli. The target populations for the use of Shigella vaccines include infants and young children in developing countries (in which the peak incidence occurs at 12-47 months of age and the S. flexneri serotypes predominate) 5-7 .S. dysenteriae 1, which produces Shiga toxin and typically carries R factors that encode resistance to multiple antibodies, waxes and wanes as a cause of epidemic severe disease in the world's least developed countries [11][12][13][14] Few bacterial pathogens have had their pathogenesis or interactions with mammalian tissues elucidated so precisely at the cellular and subcellular levels as Shigella spp. 20,21 Nevertheless, progress in attaining safe and effective Shigella vaccines has faltered. Herein, we review recent and old clinical trials that have evaluated the safety, immunogenicity and efficacy of candidate Shigella vaccines. We relate the bassis for the most popular strategies (BOX 2), the relevance of the different immune responses measured, the factors that have favoured or impeded vaccine development and, most importantly, the less...

show abstract

“…8 Several case reports have indicated severe neonatal infections with S. newport in African countries such as Kenya, Morocco, and Tanzania. 9 This case report is unique because, in our review of the literature, we did not find any published case reports of S. Newport in neonates in the United States. The Centers for Disease Control and Prevention has reported antibiotic resistance of S. newport in the United States because of the development of multidrug resistance from the use of antibiotics given to cattle.…”

Section: Discussionmentioning

confidence: 81%

Salmonella Newport Bacteremia in a 12-Day-Old Infant

Singh

Wilkins

Schade

2011

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

In the United States, Salmonella infections (salmonellosis) cause multiple medical problems. Although the most common presenting symptom is diarrhea, bacteremia can also occur. An estimated 1.4 million cases of salmonellosis occur annually in the United States. We present a case of Salmonella bacteremia in a 12-day old infant. We discuss the presenting signs, symptoms, and management strategies for a patient younger than 28 days old (neonate) presenting with fever and diarrhea. ( J Am Board Fam Med 2011;24:214 -217.)

show abstract

Epidemiology of Sporadic Bloody Diarrhea in Rural Western Kenya

Abstract: Abstract. We conducted laboratory-based surveillance and a case-control study to characterize the epidemiology of bloody diarrhea in rural Western Kenya. From

Cited by 61 publications

References 28 publications

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road

Salmonella Newport Bacteremia in a 12-Day-Old Infant

Contact Info

Product

Resources

About