Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study

Irene N Kasumba; Henry Badji; Helen Powell; M Jahangir Hossain; Richard Omore; Samba O Sow; Jennifer R Verani; James A Platts-Mills; Marc-Alain Widdowson; Syed M A Zaman; Jennifer Jones; Sunil Sen; Jasnehta Permala-Booth; Shamima Nasrin; Anna Roose; Dilruba Nasrin; John Benjamin Ochieng; Jane Juma; Sanogo Doh; Joquina Chiquita M Jones; Martin Antonio; Alex O Awuor; Ciara E Sugerman; Nora Watson; Christopher Focht; Jie Liu; Eric Houpt; Karen L Kotloff; Sharon M Tennant

doi:10.1093/cid/ciac969

Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study

Irene N Kasumba, Henry Badji, Helen Powell, M Jahangir Hossain, Richard Omore, Samba O Sow, Jennifer R Verani, James A Platts-Mills, Marc-Alain Widdowson, Syed M A Zaman, Jennifer Jones, Sunil Sen, Jasnehta Permala-Booth, Shamima Nasrin, Anna Roose, Dilruba Nasrin, John Benjamin Ochieng, Jane Juma, Sanogo Doh, Joquina Chiquita M JonesMartin Antonio, Alex O Awuor, Ciara E Sugerman, Nora Watson, Christopher Focht, Jie Liu, Eric Houpt, Karen L Kotloff, Sharon M Tennant

Institute of Tropical Medicine

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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Abstract

BACKGROUND: We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.

METHODS: Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.

RESULTS: The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).

CONCLUSIONS: A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.

Original language	English
Journal	Clinical Infectious Diseases
Volume	76
Issue number	Suppl.1
Pages (from-to)	S66-S76
Number of pages	11
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/ciac969
Publication status	Published - 2023

Keywords

Child
Infant
Humans
Child, Preschool
Infant, Newborn
Dysentery, Bacillary/epidemiology
Azithromycin
Ceftriaxone
Shigella
Anti-Bacterial Agents/therapeutic use
Ciprofloxacin
Diarrhea/epidemiology
Mali/epidemiology
Microbial Sensitivity Tests

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10.1093/cid/ciac969Licence: CC BY

2023cidi0S66Final published version, 1.12 MBLicence: CC BY

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Kasumba, I. N., Badji, H., Powell, H., Hossain, M. J., Omore, R., Sow, S. O., Verani, J. R., Platts-Mills, J. A., Widdowson, M.-A., Zaman, S. M. A., Jones, J., Sen, S., Permala-Booth, J., Nasrin, S., Roose, A., Nasrin, D., Ochieng, J. B., Juma, J., Doh, S., ... Tennant, S. M. (2023). Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study. Clinical Infectious Diseases, 76(Suppl.1), S66-S76. https://doi.org/10.1093/cid/ciac969

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title = "Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study",

abstract = "BACKGROUND: We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.METHODS: Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.RESULTS: The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).CONCLUSIONS: A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.",

keywords = "Child, Infant, Humans, Child, Preschool, Infant, Newborn, Dysentery, Bacillary/epidemiology, Azithromycin, Ceftriaxone, Shigella, Anti-Bacterial Agents/therapeutic use, Ciprofloxacin, Diarrhea/epidemiology, Mali/epidemiology, Microbial Sensitivity Tests",

author = "Kasumba, {Irene N} and Henry Badji and Helen Powell and Hossain, {M Jahangir} and Richard Omore and Sow, {Samba O} and Verani, {Jennifer R} and Platts-Mills, {James A} and Marc-Alain Widdowson and Zaman, {Syed M A} and Jennifer Jones and Sunil Sen and Jasnehta Permala-Booth and Shamima Nasrin and Anna Roose and Dilruba Nasrin and Ochieng, {John Benjamin} and Jane Juma and Sanogo Doh and Jones, {Joquina Chiquita M} and Martin Antonio and Awuor, {Alex O} and Sugerman, {Ciara E} and Nora Watson and Christopher Focht and Jie Liu and Eric Houpt and Kotloff, {Karen L} and Tennant, {Sharon M}",

note = "FTX; {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. (CC BY 4.0)",

year = "2023",

doi = "10.1093/cid/ciac969",

language = "English",

volume = "76",

pages = "S66--S76",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "Suppl.1",

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Kasumba, IN, Badji, H, Powell, H, Hossain, MJ, Omore, R, Sow, SO, Verani, JR, Platts-Mills, JA, Widdowson, M-A, Zaman, SMA, Jones, J, Sen, S, Permala-Booth, J, Nasrin, S, Roose, A, Nasrin, D, Ochieng, JB, Juma, J, Doh, S, Jones, JCM, Antonio, M, Awuor, AO, Sugerman, CE, Watson, N, Focht, C, Liu, J, Houpt, E, Kotloff, KL & Tennant, SM 2023, 'Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study', Clinical Infectious Diseases, vol. 76, no. Suppl.1, pp. S66-S76. https://doi.org/10.1093/cid/ciac969

TY - JOUR

T1 - Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study

AU - Kasumba, Irene N

AU - Badji, Henry

AU - Powell, Helen

AU - Hossain, M Jahangir

AU - Omore, Richard

AU - Sow, Samba O

AU - Verani, Jennifer R

AU - Platts-Mills, James A

AU - Widdowson, Marc-Alain

AU - Zaman, Syed M A

AU - Jones, Jennifer

AU - Sen, Sunil

AU - Permala-Booth, Jasnehta

AU - Nasrin, Shamima

AU - Roose, Anna

AU - Nasrin, Dilruba

AU - Ochieng, John Benjamin

AU - Juma, Jane

AU - Doh, Sanogo

AU - Jones, Joquina Chiquita M

AU - Antonio, Martin

AU - Awuor, Alex O

AU - Sugerman, Ciara E

AU - Watson, Nora

AU - Focht, Christopher

AU - Liu, Jie

AU - Houpt, Eric

AU - Kotloff, Karen L

AU - Tennant, Sharon M

N1 - FTX; © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. (CC BY 4.0)

PY - 2023

Y1 - 2023

N2 - BACKGROUND: We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.METHODS: Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.RESULTS: The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).CONCLUSIONS: A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.

AB - BACKGROUND: We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.METHODS: Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.RESULTS: The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).CONCLUSIONS: A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.

KW - Child

KW - Infant

KW - Humans

KW - Child, Preschool

KW - Infant, Newborn

KW - Dysentery, Bacillary/epidemiology

KW - Azithromycin

KW - Ceftriaxone

KW - Shigella

KW - Anti-Bacterial Agents/therapeutic use

KW - Ciprofloxacin

KW - Diarrhea/epidemiology

KW - Mali/epidemiology

KW - Microbial Sensitivity Tests

U2 - 10.1093/cid/ciac969

DO - 10.1093/cid/ciac969

M3 - A1: Web of Science-article

C2 - 37074444

SN - 1058-4838

VL - 76

SP - S66-S76

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - Suppl.1

ER -

Shigella in Africa: new insights from the Vaccine Impact on Diarrhea in Africa (VIDA) Study

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Keywords

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