Rolfo Florencia, Marin Gustavo Horacio, Silberman Martin, Pattin Jorgelina, Giugnio Silvina, Gatti Blanca, Bettiol Marisa, Rigoni Ana
Comision Nacional Salud Investiga, National Ministry of Health, Argentina.
J Infect Dev Ctries. 2012 Apr 13;6(4):324-8. doi: 10.3855/jidc.1977.
Shigellosis represents one of the main causes of bloody diarrhoea in South America. This study aimed to establish the incidence of shigellosis in an urban zone of Buenos Aires, Argentina, by examining the type of Shigella and living conditions associated with this infection.
Between January 2009 and December 2010 we analyzed shigellosis in children admitted to the public health service with bloody diarrhoea from La Plata, the capital of Buenos Aires, Argentina. A total of 372 children under 15 years old with Shigella present in their stool samples were admitted to the study. Variables studied were patient age, type of Shigella, family economic status, and access to sewage services and safe drinking water.
Shigella flexneri was found to be present in 66.8% of the cases. Incidence was 187 cases/year/100,000 children under 15 years old. Cases were mainly observed during the summer (38.5%) in the population of under 5 years old (69.1% of all cases). The risk of shigellosis increased 12 times in those children who lacked safe drinking water and this risk increased 1.5 times in the population without sewage services. Fewer cases of shigellosis were noted in downtown areas, while hot spots were identified in the suburbs. Treating one case of shigellosis has a local cost of US $976 while assuring safe drinking water and sewage services for one family costs US $634.
Incidence of shigellosis in urban areas is associated with quality of water and sewage services. Policies aimed at providing education and improving public utilities networks can help to reduce the incidence of shigellosis.
志贺氏菌病是南美洲血性腹泻的主要病因之一。本研究旨在通过检测志贺氏菌类型以及与该感染相关的生活条件，确定阿根廷布宜诺斯艾利斯一个城区的志贺氏菌病发病率。
2009年1月至2010年12月期间，我们分析了阿根廷布宜诺斯艾利斯省省会拉普拉塔市因血性腹泻入住公共卫生服务机构的儿童中的志贺氏菌病情况。共有372名15岁以下粪便样本中检测出志贺氏菌的儿童纳入研究。研究变量包括患者年龄、志贺氏菌类型、家庭经济状况以及获得污水服务和安全饮用水的情况。
66.8%的病例中发现福氏志贺氏菌。发病率为每年187例/10万15岁以下儿童。病例主要在夏季观察到（38.5%），在5岁以下人群中（占所有病例的69.1%）。缺乏安全饮用水的儿童感染志贺氏菌病的风险增加了12倍，而没有污水服务的人群中这一风险增加了1.5倍。市中心地区志贺氏菌病病例较少，而在郊区发现了热点地区。治疗一例志贺氏菌病的当地成本为976美元，而为一个家庭确保安全饮用水和污水服务的成本为634美元。
城区志贺氏菌病的发病率与水和污水服务质量相关。旨在提供教育和改善公共事业网络的政策有助于降低志贺氏菌病的发病率。
