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dc.contributor.authorVubil, Delfino
dc.contributor.authorAcácio, Sozinho
dc.contributor.authorLevine, Myron M.
dc.contributor.authorKotloff, Karen L.
dc.date.accessioned2019-07-01T18:29:04Z
dc.date.available2019-07-01T18:29:04Z
dc.date.issued2018-01-01
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85057607455&origin=inward
dc.identifier.urihttp://hdl.handle.net/10713/9843
dc.description.abstractObjectives: During the period from December 2007 to November 2012, the epidemiology of diarrhea caused by Shigella was studied among children <5 years of age residing in Manhiça District, Southern Mozambique. Materials and methods: Children from 0 to 5 years with moderate-to-severe diarrhea (MSD) and less severe diarrhea (LSD) were enrolled along with matched controls (by age, gender, and neighborhood). Age-stratified logistic regression analyses were conducted to identify clinical features and risk factors associated with Shigella positivity in cases of diarrhea. The impact of antibiotic treatment was assessed for patients with known outcome. Results: A total of 916 cases of MSD and 1979 matched controls, and 431 cases of LSD with equal number of controls were enrolled. Shigella was identified as significant pathogen in both cases of MSD and LSD compared to their respective controls. Shigella was detected in 3.9% (17/431) of LSD compared to 0.5% (2/431) in controls (P=0.001) and in 6.1% (56/916) of MSD cases compared to 0.2% (4/1979) in controls (P<0.0001), with an attributable fraction of 8.55% (95% CI: 7.86–9.24) among children aged 12–23 months. Clinical symptoms associated to Shigella among MSD cases included dysentery, fever, and rectal prolapse. Water availability, giving stored water to child, washing hands before preparing baby’s food, and mother as caretaker were the protective factors against acquiring diarrhea caused by Shigella. Antibiotic treatment on admission was associated with a positive children outcome. Conclusion: Shigella remains a common pathogen associated with childhood diarrhea in Mozambique, with dysentery being a significant clinical feature of shigellosis. Adherence to the basic hygiene rules and the use of antibiotic treatment could contribute to the prevention of most of diarrhea due to Shigella. © 2018 Vubil et al.en_US
dc.description.sponsorshipThis study was part the GEMS study funded by the Bill and Melinda Gates Foundation. CISM receives core funds from Spanish Agency for International Cooperation and Development (AECID). Delfino Vubil received a fellowship from Fundação Calouste Gulbenkian – Programa Gulbenkian Parcerias para o Desenvolvimento (www.gulbenkian.pt).en_US
dc.description.urihttps://www.doi.org/10.2147/IDR.S177579
dc.language.isoen_USen_US
dc.publisherDove Medical Press Ltd.en_US
dc.relation.ispartofInfection and Drug Resistanceen_US
dc.subjectEpidemiologyen_US
dc.subjectLess severe diarrheaen_US
dc.subjectModerate-to-severe diarrheaen_US
dc.subjectShigellaen_US
dc.subjectEpidemiologyen_US
dc.subjectLess severe diarrheaen_US
dc.subjectModerate-to-severe diarrheaen_US
dc.subjectShigellaen_US
dc.titleClinical features, risk factors, and impact of antibiotic treatment of diarrhea caused by Shigella in children less than 5 years in Manhiça district, rural Mozambiqueen_US
dc.typeArticleen_US
dc.identifier.doi10.2147/IDR.S177579


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