Use of population-based surveillance to define the high incidence of shigellosis in an urban slum in Nairobi, Kenya.
Use of population-based surveillance to define the high incidence of shigellosis in an urban slum in Nairobi, Kenya.
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DOI：
10.1371/journal.pone.0058437
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Breiman RF
中科院分区：
文献类型：
--
作者：
Njuguna HN;Cosmas L;Williamson J;Nyachieo D;Olack B;Ochieng JB;Wamola N;Oundo JO;Feikin DR;Mintz ED;Breiman RF
在世界范围内，志贺氏菌每年造成约1.6亿例感染和超过100万例死亡。然而，非洲城市贫民窟的发病率数据有限。我们通过基于人群的监测调查了肯尼亚内罗毕人口稠密的城市居民区内志贺菌病的流行病学和药物敏感模式。监测参与者每2周在家中接受社区访谈。受试者还可以自由前往监测区域的指定研究诊所，在那里从腹泻（24小时内≥3次稀便）或痢疾（过去24小时内≥1次可见便血）患者中采集粪便标本。我们调整了粗发病率的参与者在家庭访视粪便收集标准谁报告访问另一个诊所。 志贺氏菌属分离出224（23%）的976粪便标本。总体校正发病率为408/100，000观察人年（PYO），34-49岁成人的发病率最高（1，575/100，000 PYO）。分离株为：福氏志贺菌（64%）、志贺菌（64%）;紫茎泽兰属（11%）、S. sonnei（9%）和S. boydii（5%）。90%以上的志贺菌对甲氧苄啶-磺胺甲恶唑和磺胺异恶唑耐药。其他耐药包括萘啶酸（3%）、环丙沙星（1%）和头孢曲松（1%）。在这个肯尼亚城市贫民窟，每年每200人中就有1人患志贺氏菌病，发病率与一些亚洲国家相似。除了开发有效的志贺氏菌疫苗外，还需要在城市贫民窟提供安全饮用水，改善环境卫生和个人卫生，以减少疾病负担。
Worldwide, Shigella causes an estimated 160 million infections and >1 million deaths annually. However, limited incidence data are available from African urban slums. We investigated the epidemiology of shigellosis and drug susceptibility patterns within a densely populated urban settlement in Nairobi, Kenya through population-based surveillance. Surveillance participants were interviewed in their homes every 2 weeks by community interviewers. Participants also had free access to a designated study clinic in the surveillance area where stool specimens were collected from patients with diarrhea (≥3 loose stools within 24 hours) or dysentery (≥1 stool with visible blood during previous 24 hours). We adjusted crude incidence rates for participants meeting stool collection criteria at household visits who reported visiting another clinic. Shigella species were isolated from 224 (23%) of 976 stool specimens. The overall adjusted incidence rate was 408/100,000 person years of observation (PYO) with highest rates among adults 34–49 years old (1,575/100,000 PYO). Isolates were: Shigella flexneri (64%), S. dysenteriae (11%), S. sonnei (9%), and S. boydii (5%). Over 90% of all Shigella isolates were resistant to trimethoprim-sulfamethoxazole and sulfisoxazole. Additional resistance included nalidixic acid (3%), ciprofloxacin (1%) and ceftriaxone (1%). More than 1 of every 200 persons experience shigellosis each year in this Kenyan urban slum, yielding rates similar to those in some Asian countries. Provision of safe drinking water, improved sanitation, and hygiene in urban slums are needed to reduce disease burden, in addition to development of effective Shigella vaccines.
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影响因子：
11.8
作者：
Crump, JA;Barrett, TJ;Angulo, FJ
通讯作者：
Angulo, FJ
影响因子：
7.7
作者：
BAQUI, AH;BLACK, RE;SACK, RB
通讯作者：
SACK, RB
影响因子：
7.7
作者：
ALAM, N;HENRY, FJ;RAHAMAN, MM
通讯作者：
RAHAMAN, MM
DOI：
10.4269/ajtmh.1997.56.258
发表时间：
1997-03-01
影响因子：
3.3
作者：
Ahmed, F;Clemens, JD;Haque, E
通讯作者：
Haque, E
影响因子：
11.8
作者：
BENNISH, ML;SALAM, MA;RONSMANS, C
通讯作者：
RONSMANS, C