Epidemiology of Shigella species and serotypes in children: a retrospective substudy of the MAL-ED observational birth cohort study

作者：Elizabeth T. Rogawski McQuade, Jie Liu, Mustafa Mahfuz, Alexandre Havt, Tintu Varghese, Jasmin Shrestha, Furqan Kabir, Pablo Peñataro Yori, Amidou Samie, Queen Saidi, Adil Kalam, Fátima Aziz, Sahrish Muneer, Rashidul Haque, Aldo Â. M. Lima, M. Kalaivanan, Sanjaya K. Shrestha, Najeeha Talat Iqbal, Zulfiqar A Bhutta, Margaret Kosek, Pascal Bessong, Estomih Mduma, James A Platts-Mills, Eric R. Houpt · 发表于：The Lancet Microbe · 年份：2025 · DOI：10.1016/j.lanmic.2024.101064 · 被引用次数：16 · 研究领域：Escherichia coli research studies、Viral gastroenteritis research and epidemiology、Child Nutrition and Water Access

BACKGROUND: Shigellosis is a leading cause of diarrhoea in children globally. We aimed to assess the burden of specific Shigella species and Shigella flexneri serotypes, characterise their clinical syndromes and natural immunity, and evaluate their relevance as causes of diarrhoea and linear growth faltering. METHODS: In the MAL-ED birth cohort study, children younger than 17 days were enrolled from Nov 3, 2009, to Feb 29, 2012, in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, Tanzania, and South Africa and were followed up for 2 years. In this retrospective substudy, we retested Shigella quantitative PCR-positive diarrhoeal and non-diarrhoeal stool samples with molecular subtyping assays. We estimated the prevalence of specific Shigella species and serotypes, estimated their associations with diarrhoea and clinical characteristics using generalised linear mixed models, estimated their associations with linear growth using linear regression, and used longitudinal infection data to estimate protection due to previous infection using the Andersen and Gill extension of the Cox model. FINDINGS: 1715 children (874 [51·0%] male and 841 [49·0%] female) with complete follow-up to 2 years provided 45 835 stool samples collected between age 0 and 2 years. 1294 (75·5%) children had at least one Shigella detection in a non-diarrhoeal or asymptomatic stool and 507 (29·6%) had at least one Shigella-attributed diarrhoea episode. In this substudy, we were able to type 1202 samples. The m...