Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Int J Infect Dis. 2023 Apr;129:78-95. doi: 10.1016/j.ijid.2023.01.034. Epub 2023 Jan 31.
We conducted a systematic review of the longitudinal consequences of Shigella infection in children to inform the value proposition for an effective vaccine.
We searched PubMed and Embase for studies published from January 01, 1980 to December 12, 2022 and conducted in low- and middle-income countries that included longitudinal follow-up after Shigella detection among children aged <5 years, irrespective of language. We collected data on all outcomes subsequent to Shigella detection, except mortality.
Of 2627 papers identified, 52 met inclusion criteria. The median sample size of children aged <5 years was 66 (range 5-2172). Data were collected in 20 countries; 56% (n = 29) of the publications included Bangladesh. The most common outcomes related to diarrhea (n = 20), linear growth (n = 14), and the mean total cost of a Shigella episode (n = 4; range: $ 6.22-31.10). Among children with Shigella diarrhea, 2.9-61.1% developed persistent diarrhea (≥14 days); the persistence was significantly more likely among children who were malnourished, had bloody stool, or had multidrug-resistant Shigella. Cumulative Shigella infections over the first 2 years of life contributed to the greatest loss in length-for-age z-score.
We identified evidence that Shigella is associated with persistent diarrhea, linear growth faltering, and economic impact to the family.
我们对儿童志贺氏菌感染的纵向后果进行了系统评价，为有效疫苗的价值主张提供信息。
我们在 PubMed 和 Embase 上检索了 1980 年 1 月 1 日至 2022 年 12 月 12 日期间发表的、在中低收入国家进行的研究，这些研究纳入了 5 岁以下儿童在志贺氏菌检测后的纵向随访，无论语言如何。我们收集了所有继发于志贺氏菌检测的结果数据，但不包括死亡率。
在 2627 篇论文中，有 52 篇符合纳入标准。年龄<5 岁的儿童的中位样本量为 66（范围 5-2172）。数据收集于 20 个国家；56%（n=29）的出版物包括孟加拉国。最常见的结果与腹泻（n=20）、线性生长（n=14）和单次志贺氏菌感染的平均总成本（n=4；范围：6.22-31.10）有关。在患有志贺氏菌腹泻的儿童中，2.9-61.1%发展为持续性腹泻（≥14 天）；营养不良、有血便或存在多重耐药志贺氏菌的儿童更有可能持续性腹泻。生命头 2 年累积的志贺氏菌感染导致年龄别身长 z 评分损失最大。
我们发现证据表明，志贺氏菌与持续性腹泻、线性生长迟缓以及对家庭的经济影响有关。
