Chakraborty Subhra, Dash Sampa, Antara Nowrin Akbar, Roy Bharati Rani, Mamun Shamim Al, Ali Mohammad, Naz Farina, Johura Fatema-Tuz, Lewis Jade, Afroze Farzana, Hasan Abm Ali, Sack David A, Ram Malathi, Tofail Fahmida, Ahmed Tahmeed, Faruque A S G
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
icddr,b, Dhaka 1212, Bangladesh.
Microorganisms. 2024 Aug 15;12(8):1677. doi: 10.3390/microorganisms12081677.
(1) spp. (Shigella) is known for causing dysentery with blood in stool, but most children infected with Shigella have non-dysentery Shigella-associated diarrhea (NDSD). The World Health Organization recommends the use of antibiotics when diarrhea is bloody, leaving most NDSD cases untreated. The absence of dysentery may not indicate a low risk of death and severe morbidity. Rapid diagnosis and treatment of shigellosis in vulnerable, young children may be lifesaving. INSIGHT aims to determine the potential benefit of identifying NDSD cases (n = 296) and their outcomes compared to cases of [DS (n = 148)] and non-Shigella watery diarrhea [WD (n = 148)]. (2) Children seeking care at hospitals in Bangladesh will be enrolled and followed for 1 year (NDSD and DS) or 90 days (WD). We will determine the impact of NDSD on morbidity, mortality, gut health, nutritional status, and cognitive development compared to DS and WD in children and whether the simple "Rapid LAMP-based Diagnostic Test (RLDT)" can accelerate the detection and treatment of shigellosis in the clinical settings of rural Bangladesh. (3) INSIGHT will determine the impact of NDSD in children and determine if the treatment guidelines of shigellosis need to be revisited to improve clinical outcomes and the development of these children.
(1) 志贺氏菌属（志贺菌）以引起便血性痢疾而闻名，但大多数感染志贺菌的儿童患有非痢疾性志贺菌相关性腹泻（NDSD）。世界卫生组织建议在腹泻带血时使用抗生素，这使得大多数NDSD病例得不到治疗。没有痢疾症状可能并不意味着死亡和严重发病风险低。对脆弱的幼儿进行志贺菌病的快速诊断和治疗可能会挽救生命。INSIGHT旨在确定识别NDSD病例（n = 296）的潜在益处及其与痢疾病例[DS（n = 148）]和非志贺菌水样腹泻[WD（n = 148）]病例相比的结果。(2) 在孟加拉国医院寻求治疗的儿童将被纳入研究，并随访1年（NDSD和DS）或90天（WD）。我们将确定与DS和WD相比，NDSD对儿童发病率、死亡率、肠道健康、营养状况和认知发展的影响，以及简单的“基于环介导等温扩增的快速诊断测试（RLDT）”是否能在孟加拉国农村的临床环境中加速志贺菌病的检测和治疗。(3) INSIGHT将确定NDSD对儿童的影响，并确定是否需要重新审视志贺菌病的治疗指南，以改善这些儿童的临床结局和发育情况。
