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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Systemic shigellosis in South Africa
Clinical Infectious Diseases, Volume 54, No. 10, Year 2012
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Description
Background. Systemic disease due to shigellae is associated with human immunodeficiency virus (HIV), malnutrition, and other immunosuppressed states. We examined the clinical and microbiologic characteristics of systemic shigellosis in South Africa, where rates of HIV infection are high. Methods. From 2003 to 2009, 429 cases of invasive shigellosis were identified through national laboratory-based surveillance. At selected sites, additional information was captured on HIV serostatus and outcome. Isolates were serotyped and antimicrobial susceptibility testing performed. Results. Most cases of systemic shigellosis were diagnosed on blood culture (408 of 429 cases; 95%). HIV prevalence was 67% (80 of 120 cases), highest in patients aged 5-54 years, and higher among females (55 of 70 cases; 79%) compared with males (25 of 48 cases; 52%; P = 002). HIV-infected people were 4.1 times more likely to die than HIV-uninfected cases (case-fatality ratio, 29 of 78 HIV-infected people [37%] vs 5 of 40 HIV-uninfected people [13%]; P = 008; 95% confidence interval [CI], 1.5-11.8). The commonest serotype was Shigella flexneri 2a (89 of 292 serotypes [30.5%]). Pentavalent resistance occurred in 120 of 292 isolates (41.1%). There was no difference in multidrug resistance between HIV-infected patients (33 of 71 [46%]) and uninfected patients (12 of 33 [36%]; 95% CI, .65-3.55). Conclusions. Systemic shigellosis is associated with HIV-infected patients, primarily in older girls and women, potentially due to the burden of caring for sick children in the home; interventions need to be targeted here. Death rates are higher in HIV-infected versus uninfected individuals. © The Author 2012.
Authors & Co-Authors
Keddy, Karen Helena
South Africa, Johannesburg
National Institute for Communicable Diseases
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Sooka, Arvinda
South Africa, Johannesburg
National Institute for Communicable Diseases
Crowther-Gibson, Penny
South Africa, Johannesburg
National Institute for Communicable Diseases
Quan, Vanessa Cecilia
South Africa, Johannesburg
National Institute for Communicable Diseases
Meiring, Susan T.
South Africa, Johannesburg
National Institute for Communicable Diseases
Cohen, Cheryl D.
South Africa, Johannesburg
National Institute for Communicable Diseases
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
Nana, Trusha
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Sriruttan, Charlotte
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Seetharam, Sharona
South Africa, Johannesburg
University of the Witwatersrand Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Hoosen, Anwar Ahmed
South Africa, Pretoria
Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Naicker, Preneshni R.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Elliott, Eugenne
South Africa, Bloemfontein
University of the Free State, School of Medicine
South Africa, Johannesburg
National Health Laboratory Service
Haffejee, Sumayya
South Africa, Congella
University of Kwazulu-natal, Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Whitelaw, Andrew C.
South Africa, Cape Town
Faculty of Health Sciences
South Africa, Johannesburg
National Health Laboratory Service
Klugman, K. P.
United States, Atlanta
Rollins School of Public Health
United States, Atlanta
Emory University
Statistics
Citations: 40
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1093/cid/cis224
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
South Africa
Participants Gender
Female