STUDIES OF THE EPIDEMIOLOGY OF PEDIATRIC SHIGELLOSIS IN BANGLADESH

孟加拉国儿童志贺氏菌病流行病学研究

• 批准号: 3778543
• 负责人: J D CLEMENS
• 金额: --
• 依托单位: EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3778543
• 关键词: Bangladesh; Shigella dysenteriae; age difference; bacillary dysentery; body physical characteristic; breast feeding; diet; disease /disorder proneness /risk; environmental protection; epidemiology; feces analysis; field study; human subject; interview; nutrition related tag; population survey; preschool child (1-5); rural area; seasons; vitamin A deficiency

The purpose of this field project is to evaluate the epidemiological patterns and determinants of pediatric shigellosis occurring among residents in a research field site in rural Bangladesh who have had a documented recent exposure to a neighborhood resident having Shigella dysentery. The project entailed assembly of 1934 children under 5 years of age, from 1335 families residing in 240 neighborhoods having a resident who presented for treatment of documented Shigella dysentery within 1 week of the initiation of active neighborhood surveillance. Following assembly of these children, each was followed with intensive active surveillance for one month. This surveillance included, at baseline, sociodemographic characterization, ascertainment of dietary and anthropometric status, and measurement of serum vitamin A. Subjects were visited according to a systematic schedule to ascertain symptomatic histories related to diarrhea, and to collect fecal specimens for microbiological characterization. Analyses of the data thus far have demonstrated that the occurrence of Shigella diarrhea was related to age (being highest in the third year of life), nutritional status (being higher in stunted children), season (being lowest during the monsoon season in the summer months), and breast-feeding status (being lower among breast-fed children, even up to 36 months of age). The presence of a latrine was not related to the risk, due to the fact that the presence of an unsanitary hanging latrine elevated the risk, while the presence of a sanitary slightly depressed the risk. Interestingly, the protective effect of breast feeding was almost entirely attributable to the increase in risk of shigellosis which occurred during the initial 3 months following cessation of breast feeding. Analyses are now in progress to determine the frequency and determinants of the progression of Shigella diarrhea from acute to chronic form and to assess the role of vitamin A deficiency as a risk factor for acute and persistent shigellosis.

这一实地项目的目的是评估流行病学 儿童志贺氏菌病发生的模式和决定因素 在孟加拉国农村的一个研究现场， 记录了最近接触过一个患有志贺氏菌的邻居 痢疾。 该项目需要收集1934名5岁以下的儿童 年龄，从1335个家庭居住在240个社区，有一个居民 1周内因志贺氏菌痢疾就诊 启动积极的邻里监视。 以下装配 在这些儿童中， 一个月。 该监测包括基线时的社会人口统计学 表征，确定饮食和人体测量状态，以及 血清维生素A测定。 受试者根据 系统性时间表，以确定与以下疾病相关的症状史 腹泻，并收集粪便标本进行微生物 特征化 迄今为止的数据分析表明， 志贺菌腹泻的发生与年龄有关， 营养状况（发育迟缓的儿童 儿童），季节（在夏季季风季节最低 月）和母乳喂养状况（母乳喂养儿童中的比例较低， 甚至长达36个月的年龄）。 厕所的存在与 由于不卫生的绞刑 厕所增加了风险，而卫生间的存在则稍微增加了风险。 降低了风险。 有趣的是，乳房的保护作用 喂养几乎完全是由于风险的增加， 在停药后最初3个月内发生的志贺氏菌病 母乳喂养。 目前正在进行分析，以确定发生频率和决定因素。 志贺氏菌腹泻从急性到慢性的发展， 评估维生素A缺乏症作为急性和 持续性志贺氏菌病。