BACKGROUND: Encephalopathy is a serious neurologic complication from shigellosis often with fatal outcome but data on simple clinical and sociodemographic predicting factors are limited. We sought to identify those factors in children. METHODS: In this unmatched case-control design, children of both sexes, aged 0 to 15 years having positive stool culture for Shigella from 1997 to 2006 were studied. Children with Shigella encephalopathy constituted the cases (n = 29), whereas randomly selected children with shigellosis having no encephalopathy constituted controls (n = 87). RESULTS: The case-fatality was significantly higher among the cases than among controls (7% vs. 0%, RR: 4.2, CI: 3.0-5.9, P = 0.013). In logistic regression analysis, children with Shigella encephalopathy more often had an illiterate father (OR: 5.4, 95% CI: 1.1-27.1, P = 0.038), stopped breast-feeding in the neonatal period (OR: 41.3, 95% CI: 4.2-403.1, P = 0.001), had dehydrating diarrhea (OR: 9.9, 95% CI: 2.1-45.9, P = 0.004) with a duration of <1 day (OR: 29.4, 95% CI: 2.1-43.2, P = 0.004), and were more likely to be severely stunted (OR: 6.4, 95% CI: 1.2-34.9, P = 0.033). CONCLUSION: Education of parents about the value of exclusive breast-feeding and of prompt hydration in children with Shigella is critical to minimize morbidity and deaths.
BACKGROUND:Encephalopathy is a serious neurologic complication from shigellosis often with fatal outcome but data on simple clinical and sociodemographic predicting factors are limited. We sought to identify those factors in children. METHODS: In this unmatched case-control design, children of both sexes, aged 0 to 15 years having positive stool culture for Shigella from 1997 to 2006 were studied. Children with Shigella encephalopathy constituted the cases (n = 29), whereas randomly selected children with shigellosis having no encephalopathy constituted controls (n = 87). RESULTS: The case-fatality was significantly higher among the cases than among controls (7% vs. 0%, RR: 4.2, CI: 3.0-5.9, P = 0.013). In logistic regression analysis, children with Shigella encephalopathy more often had an illiterate father (OR: 5.4, 95% CI: 1.1-27.1, P = 0.038), stopped breast-feeding in the neonatal period (OR: 41.3, 95% CI: 4.2-403.1, P = 0.001), had dehydrating diarrhea (OR: 9.9, 95% CI: 2.1-45.9, P = 0.004) with a duration of <1 day (OR: 29.4, 95% CI: 2.1-43.2, P = 0.004), and were more likely to be severely stunted (OR: 6.4, 95% CI: 1.2-34.9, P = 0.033). CONCLUSION: Education of parents about the value of exclusive breast-feeding and of prompt hydration in children with Shigella is critical to minimize morbidity and deaths.
Authors: P B Pavlinac; D M Denno; G C John-Stewart; F M Onchiri; J M Naulikha; E A Odundo; C E Hulseberg; B O Singa; L E Manhart; J L Walson Journal: J Pediatric Infect Dis Soc Date: 2015-07-12 Impact factor: 3.164
Authors: Mohammod J Chisti; Mohammed A Salam; Jonathan Harvey Smith; Tahmeed Ahmed; Hasan Ashraf; Pradip K Bardhan; Mark A C Pietroni Journal: PLoS One Date: 2011-10-03 Impact factor: 3.240