Relative transmissibility of shigellosis among male and female individuals: a modeling study in Hubei Province, China.

ABSTRACT

BACKGROUND: Developing countries exhibit a high disease burden from shigellosis. Owing to the different incidences in males and females, this study aims to analyze the features involved in the transmission of shigellosis among male (subscript m) and female (subscript f) individuals using a newly developed sex-based model. METHODS: The data of reported shigellosis cases were collected from the China Information System for Disease Control and Prevention in Hubei Province from 2005 to 2017. A sex-based Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model was applied to explore the dataset, and a sex-age-based SEIAR model was applied in 2010 to explore the sex- and age-specific transmissions. RESULTS: From 2005 to 2017, 130 770 shigellosis cases (including 73 981 male and 56 789 female cases) were reported in Hubei Province. The SEIAR model exhibited a significant fitting effect with the shigellosis data (P <  0.001). The median values of the shigellosis transmission were 2.3225 × 108 for SARmm (secondary attack rate from male to male), 2.5729 × 108 for SARmf, 2.7630 × 10-8 for SARfm, and 2.1061 × 10-8 for SARff. The top five mean values of the transmission relative rate in 2010 (where the subscript 1 was defined as male and age ≤ 5 years, 2 was male and age 6 to 59 years, 3 was male and age ≥ 60 years, 4 was female and age ≤ 5 years, 5 was female and age 6 to 59 years, and 6 was male and age ≥ 60 years) were 5.76 × 10-8 for ß61, 5.32 × 10-8 for ß31, 4.01 × 10-8 for ß34, 7.52 × 10-9 for ß62, and 6.04 × 10-9 for ß64. CONCLUSIONS: The transmissibility of shigellosis differed among male and female individuals. The transmissibility between the genders was higher than that within the genders, particularly female-to-male transmission. The most important route in children (age ≤ 5 years) was transmission from the elderly (age ≥ 60 years). Therefore, the greatest interventions should be applied in females and the elderly.