Pathogenic surveillance and related factors on bacillary dysentery in Beijing, 2008-2017 / 中华流行病学杂志

Objective: To analyze the pathogenic surveillance programs and related factors on bacillary dysentery in Beijing, 2008-2017, to provide evidence for the practices of diagnosis, treatment and prevention of the disease. Methods: Analysis was conducted on surveillance data of bacillary dysentery, collected from the surveillance areas of national bacillary dysentery in Beijing. Shigella positive rate of stool samples were used as the gold standard while detection rate of Shigella, diagnostic accordance rate and resistance were computed on data from the surveillance programs. Chi-square test was used to compare the rates and unconditional logistic regression was used to analyze the related factors of Shigella infection. Results: Both the reported incidence rate on bacillary dysentery and detection rate of Shigella in diarrhea patients showed significantly decreasing trend, from 2008 to 2017. The accordance rate of bacillary dysentery was only 7.80% (111/1 423). Shigella sonnei was the most frequently isolated strain (73.95%, 159/215) followed by Shigella flexnery. Results from the multivariate logistic regression of Shigella positive rate revealed that among those patients who were routine test of stool positive vs. routine test of stool positive (OR=1.863, 95%CI: 1.402-2.475), onset from July to October vs. other months'time (OR=7.271, 95%CI: 4.514-11.709) temperature ≥38 ℃vs. temperature <38 ℃(OR=4.516, 95%CI: 3.369-6.053) and age from 6 to 59 years old vs. other ages (OR=1.617, 95%CI: 1.085-2.410), presenting higher positive detection rates of Shigella from the stool tests. The resistant rates on ampicillin and nalidixic acid were 97.57% (201/206) and 94.90% (186/196), both higher than on other antibiotics. The resistant rates on ciprofloxacin (16.33%, 32/196), ofloxacin (9.57%, 11/115) and on amoxilin (15.05%, 31/206) were relatively low. The resistant rate appeared higher on Shigella flexnery than on Shigella sonnei. The proportion of strains with resistance on 3 more drugs, was 30.00%(21/70). Conclusions: The diagnostic accordance rate of bacillary dysentery in Beijing was low, with severe resistance of Shigella. Our findings suggested that clinicians should take multiple factors into account in their practices about epidemiological history, clinical symptom and testing results for diarrhea patients.

Carga de salmonelosis y shigelosis en cuatro departamentos de Guatemala, 2010 / Burden of salmonellosis and shigellosis in four departments of Guatemala, 2010

OBJETIVO: Estimar la carga de enfermedad por Salmonella spp. y Shigella spp. en cuatro departamentos de Guatemala en 2010. MÉTODOS: Estudio de carga de enfermedad basado en el análisis documental de las encuestas poblacionales publicadas, los archivos de laboratorio y los datos de vigilancia del Sistema de Información Gerencial de Salud (SIGSA) de cuatro departamentos de Guatemala: Huehuetenango, Jutiapa, Quetzaltenango y Santa Rosa, en 2010. La información se complementó con una encuesta a laboratorios. La carga de enfermedad se estimó según la metodología de los Centros para el Control y la Prevención de Enfermedades de los Estados Unidos de América, adaptada por la Organización Mundial de la Salud. RESULTADOS: Se encontraron 72 casos de salmonelosis y 172 de shigelosis en los datos de vigilancia. Según las encuestas poblacionales, el porcentaje de la población que consulta los servicios de salud por diarrea es de 64,7% (IC95%: 60,6%-68,7%) en Quetzaltenango y 61,0% (IC95%: 56,0%-66,0%) en Santa Rosa. En los 115 laboratorios que respondieron la encuesta (tasa de respuesta: 72,8%) se recolectaron 6 051 muestras sospechadas para coprocultivo y 3 290 para hemocultivo, y se procesaron 39,4% y 100,0% de ellas, respectivamente. Se aislaron 85 cepas de Salmonella spp. y 113 de Shigella spp. Se estimó que por cada caso notificado de salmonelosis y shigelosis existen 40 casos no informados en Quetzaltenango; 55 en Huehuetenango; 345 en Santa Rosa; y 466 en Jutiapa. La carga de enfermedad estimada varió entre 5 y 2 230 casos por 100 000 habitantes para salmonelosis y entre 60 y 1 195 casos por 100 000 habitantes para shigelosis. CONCLUSIONES: La salmonelosis y la shigelosis constituyen un importante problema de salud pública en los departamentos estudiados y en Guatemala. La carga de enfermedad por estos patógenos es mayor que la informada por el SIGSA.

OBJECTIVE: Estimate the burden of disease from Salmonella spp. and Shigella spp. in four departments of Guatemala in 2010. METHODS: Burden of disease study based on document analysis of published population surveys, laboratory files, and surveillance data from the Health Management Information System (SIGSA) in four departments of Guatemala: Huehuetenango, Jutiapa, Quetzaltenango, and Santa Rosa, in 2010. Information was supplemented by a laboratory survey. Burden of disease was estimated using methodology adapted by the World Health Organization from the United States Centers for Disease Control and Prevention. RESULTS: Surveillance data yielded 72 salmonellosis and 172 shigellosis cases. According to population surveys, the percentage of the population that consults health services for diarrhea is 64.7% (95% CI: 60.6%-68.7%) in Quetzaltenango and 61.0% (95% CI: 56.0%-66.0%) in Santa Rosa. In the 115 laboratories that answered the survey (72.8% response rate), 6 051 suspected samples were collected for stool culture and 3 290 for hemoculture; 39.4% and 100.0% of them were processed, respectively. In all, 85 Salmonella spp. and 113 Shigella spp. strains were isolated. For each reported case of salmonellosis and shigellosis, it was estimated that 40 cases are not reported in Quetzaltenango, 55 in Huehuetenango, 345 in Santa Rosa, and 466 in Jutiapa. Estimated burden of disease ranged from 5 to 2 230 cases per 100 000 population for salmonellosis and from 60 to 1 195 cases per 100 000 population for shigellosis. CONCLUSIONS: Salmonellosis and shigellosis are a major public health problem in the departments studied and in Guatemala. Burden of disease from these pathogens is higher than that reported by SIGSA.

Conocimientos sobre shigellosis y su manejo epidemiológico en personal médico / Knowledges on shigellosis and its epidemiological management in medical staff

Introducción: la Shigella como agente causal de episodios diarreicos con sangre ha sido el germen aislado con mayor frecuencia en los laboratorios clínicos, no obstante, el número de casos reportados por el Sistema de Enfermedades de Declaración Obligatoria es inferior, lo que demuestra un subregistro en su notificación. Objetivos: elevar el nivel de conocimientos de médicos y alumnos internos sobre la shigellosis. Métodos: se realizó un estudio cuasi experimental antes-después, de una intervención educativa sobre la shigellosis y su manejo epidemiológico. La investigación se hizo en los policlínicos comunitarios docentes Marcio Manduley y Nguyen Van Troi en el período de enero a junio de 2008. La muestra quedó conformada por 64 médicos, de ellos 21 eran alumnos internos. Todos expresaron su consentimiento para participar en la investigación. Se aplicó la prueba no paramétrica ji cuadrada con un nivel de significación de p < 0,05. Los datos se expresaron en valores absolutos y relativos. Resultados: antes de la intervención se observó que los conocimientos taxonómicos eran buenos en solo 9 encuestados para el 14,06 por ciento, después de la intervención, el número de personas con buen nivel de conocimientos ascendió hasta el 90,63 por ciento. Se constató que el personal médico tenía escaso nivel de conocimientos sobre los principales síntomas de inicio de la shigellosis. Los encuestados con buenos conocimientos sobre las principales medidas profilácticas para prevenir la enfermedad, aumentaron significativamente después de la intervención e igual comportamiento se observó en relación con el tratamiento idóneo en pacientes con Shigella. Conclusiones: la intervención educativa elevó el nivel de conocimientos en el personal médico sobre Shigella. Es necesario continuar promoviendo e investigando esta temática en el nivel primario de atención y extender un plan de acción no sólo a los hospitales, policlínicos y consultorios sino que...

Introduction: Shigella as causal agent of diarrheic episodes with presence of blood has been the more frequent isolated agent in clinical laboratories; however, the number of cases reported by System of Diseases of Mandatory Statement is lower demonstrating a sub-registry of its notification. Objectives: to confirm the knowledge level of medical staff on the Shigellosis. Methods: a quasi-experimental study was conducted before and after a educational intervention on the Shigellosis and its epidemiological management. Research was made in the "Marcio Manduley" and "Nguyen Van Troi" Teaching and Community polyclinics from January to June, 2008. Sample included 43 physicians and 21 internal students in which the intervention was applied. Information was obtained by application of anonymous questionnaire. Results: before intervention it was possible to verify that taxonomic knowledges were satisfactory in only 9 polled persons for a 14,06 percent, after it, the figure of persons with a good level of knowledges raised to 90,63 percent. Authors confirmed that the medical staff had limited knowledges on the main symptoms of Shigellosis onset. The persons polled with high knowledges on main prophylactic measures to prevent this disease, increase significantly after intervention and a similar behavior was noted in relation to subject on suitable treatment in Shigella patients. Conclusions: educational intervention raised the knowledge level on Shigella in the medical staff. It is necessary to continue promoting and researching this subject matter at primary care level and to extend an action plan not only to hospitals, polyclinics and consulting rooms but also to involve family...

The health belief model and factors relating to potential use of a vaccine for shigellosis in Kaeng Koi district, Saraburi province, Thailand.

Shigellosis is an important cause of morbidity and mortality throughout the world. Approximately, 1.1 million deaths occur a year due to this disease, making it the fourth leading cause of mortality worldwide. This paper explores local interest in and potential use of a vaccine for shigellosis in Thailand where Shigella poses an important public-health concern. Data for this study were collected during June-November 2002 from 522 subjects surveyed using a sociobehavioural questionnaire in Kaeng Koi district in central Thailand. The community demand and likely use of a vaccine were examined in relation to the Health Belief Model, which provides analytical constructs for investigating the multiple issues of local readiness to accept and access a new vaccine. As the key outcome variable, most respondents showed interest in receiving a vaccine against dysentery which they thought would provide useful protection against the disease. However, there was only a moderate number who perceived dysentery as serious and themselves as susceptible to it, although it was perceived to cause some burden to and additional expense for families. Most people identified a number of groups who were thought to be especially vulnerable to dysentery, such as the elderly, pre-school, and school-age children, and poor labourers. Other outcomes of the study included the identification of acceptable and convenient sites for its delivery, such as government health clinics and private clinics, and respected sources for information about the vaccine, such as health clinic personnel and community health volunteers. This information suggests that components of the Health Belief Model may be useful in identifying community acceptance of a vaccine and the means of introducing it. This health information is important for planning and implementing vaccine programmes.

Shigella em alimentos / Shigella in the foods

Comenta-se nesta breve revisao a participacao e o significado de Shigella em processos de infeccao alimentar. Sao tambem abordados as caracteristicas do microrganismo, seus fatores de virulencia e determinancia genetica.Aspectos epidemiologicos da infeccao, bem como, condicoes de crescimento e metodos de deteccao em alimentos, sao tambem abordados

Vacunación contra la shigelosis / Vaccination against shigelosis

Se define como shigelosis a la enfermedad intestinal producida por las diferentes especies del género Shigella, de las cuales el humano es el principal hospedero. Shigella es un bacilo corto, Gram-negativo, de la familia Enterobacteriaceae. La shigelosis se manifiesta en tres formas: 1) disentería clásica (sangre, moco, pus), 2) diarrea acuosa no complicada y 3) una combinación de disentería y diarrea acuosa. La mayoría de los casos de diarrea acuosa no son distinguibles de las que son ocacionadas por otras etiologías. Concluye el documento enfatizando que, no existe hasta el momento actual ninguna vacuna contra Shigella que pueda ser recomendable para la aplicación en población general. Todos los esfuerzos hasta ahora realizados han quedado en pequeños estudios en voluntarios, en los cuales se han obtenido fracasos y en otros ensayos se han vislumbrado posibles vacunas para emplear en el futuro. Dentro de los modelos experimentales de vacunas que hasta el momento hay, se está intentando corregir los posibles errores y por otra parte conjuntar los mecanismos de acción propuestos para cada tipo de vacuna. Finalmente si la shigelosis es un problema de salud pública, principalmente en los países en vías de desarrollo, son importantes los esfuerzos para lograr obtener una vacuna que en lo futuro pueda reducir uno de los principales problemas de morbilidad infantil

Vacunas en perspectiva contra los agentes etiológicos de las diarreas / Outlook vaccines against etiologic agents of diarrhea

Se ha identificado en gran parte a los agentes etiológicos de la diarrea infantil y se preparan, por métodos modernos de biotecnología, vacunas potenciales contra los más importantes (rotavirus, E. coli enterotoxígena y Shigella). La mayor parte de esas vacunas potenciales se administran por vía oral, que es preferible por estimular una inmunidad localizada en el intestino. Para combatir la diarrea endémica y epidémica y la fiebre entérica, esas vacunas deben distinguirse por su buena tolerancia, elevada eficacia, costo reducido y resultado práctico y ha de haber posibilidades óptimas de administrarlas mediante programas ampliados de inmunización. Ya es posible, e incluso inminente, el logro de vacunas específicas que mitiguen la gravedad de la diarrea infantil y la consiguiente mortalidad. Esas vacunas serán una nueva arma en la batalla contra las infecciones entéricas