Global diarrhoea-associated mortality estimates and models in children: Recommendations for dataset and study selection

Butkeviciute, Egle; Prudden, H; Jit, Mark; Smith, P. G.; Kang, Gagandeep; Riddle, Mark S.; Lopman, Benjamin A.; Pitzer, Virginia E.; Lanata, Claudio F.; Platts-Mills, James A; Breiman, Robert F.; Giersing, Birgitte; Hasso-Agopsowicz, Mateusz

doi:10.1016/j.vaccine.2021.05.086

Cited by 15 publications

(18 citation statements)

References 16 publications

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“…Consequently, regional public health officials and policy makers lack a clear appreciation of the impact that ETEC and Shigella have on child and adult health in their countries. The paucity of data, particularly at the national and sub-national levels, has created uncertainties in the reported mortality estimates [8,9]. Morbidity and mortality estimates are critical to support investment decision making, and ultimately policy recommendations for vaccine development and use [9].…”

Section: Introductionmentioning

confidence: 99%

“…The paucity of data, particularly at the national and sub-national levels, has created uncertainties in the reported mortality estimates [8,9]. Morbidity and mortality estimates are critical to support investment decision making, and ultimately policy recommendations for vaccine development and use [9]. As promising vaccine candidates for ETEC and Shigella move toward field trials in endemic areas, an improved understanding of the epidemiology of both pathogens and identification of high transmission hotspots of these diseases will be critical to plan Phase III trials to assess the potential benefits of vaccine use [8].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a simple, rapid and field-adapted diagnostic assay for enterotoxigenic E. coli and Shigella

et al. 2022

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Understanding the global burden of enterotoxigenic E. coli (ETEC) and Shigella diarrhea as well as estimating the cost effectiveness of vaccines to control these two significant pathogens have been hindered by the lack of a diagnostic test that is rapid, simple, sensitive, and can be applied to the endemic countries. We previously developed a simple and rapid assay, Rapid Loop mediated isothermal amplification based Diagnostic Test (RLDT) for the detection of ETEC and Shigella spp. (Shigella). In this study, the RLDT assay was evaluated in comparison with quantitative PCR (qPCR), culture and conventional PCR for the detection of ETEC and Shigella. This validation was performed using previously collected stool samples from endemic countries, from the travelers to the endemic countries, as well as samples from a controlled human infection model study of ETEC. The performance of RLDT from dried stool spots was also validated. RLDT resulted in excellent sensitivity and specificity compared to qPCR (99% and 99.2% respectively) ranging from 92.3 to 100% for the individual toxin genes of ETEC and 100% for Shigella. Culture was less sensitive compared to RLDT. No significant differences were noted in the performance of RLDT using samples from various sources or stool samples from moderate to severe diarrhea or asymptomatic infections. RLDT performed equally well in detection of ETEC and Shigella from the dried stool samples on filter papers. This study established that RLDT is sufficiently sensitive and specific to be used as a simple and rapid diagnostic assay to detect ETEC and Shigella in endemic countries to determine disease burden of these pathogens in the national and subnational levels. This information will be important to guide public health and policy makers to prioritize resources for accelerating the development and introduction of effective preventative and/or treatment interventions against these enteric infections.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of a simple, rapid and field-adapted diagnostic assay for enterotoxigenic E. coli and Shigella

et al. 2022

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“…Thirty years ago, WHO estimated Shigella to be one of the top causes of infectious disease mortality in children, responsible for almost 600,000 deaths annually in <5-year-olds [14]. In contrast, current estimates put the number of child deaths at 28-64,000 or 1/10 that amount [15]. The difference in these figures is probably due to the overall decreasing levels of diarrheal disease stemming from water, sanitation, and hygiene (WASH) interventions, combined with better diagnostic tools and epidemiological studies.…”

Section: Major Determinants Of the Relative Value Of Shigella Vaccinesmentioning

confidence: 99%

“…Mortality in target population 28,000-60,000 deaths <5 annually [15] Significant, but lower than several other potential vaccines for their respective target populations Morbidity 111 million diarrhea episodes/yr in <5; 2.1 million cases of moderate-severe stunting [24]. Significant morbidity burden in other key populations (e.g., older children, travelers, and military).…”

Section: Potential Value Driver Current Relevant Information Commentsmentioning

confidence: 99%

What Drives the Value of a Shigella Vaccine?

2022

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The development and licensure of a safe and highly efficacious Shigella vaccine has been a priority in international public health circles for decades and would represent a great scientific achievement. Nonetheless, in the context of increasingly crowded and costly childhood immunization programs, and with a myriad of other new and improved vaccines currently or soon on the market, there is no guarantee that even a highly effective Shigella vaccine would become a priority for adoption and introduction by the low- and middle-income countries that could benefit from it the most. We discuss here some of the major determinants and questions regarding the introduction of Shigella vaccines and the importance of developing a succinct, compelling public health value proposition.

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“…The major burden of Shigellosis is concentrated in low-and middle-income countries. Disappointingly, there are currently no licensed vaccinations against Shigella infection (Butkeviciute et al, 2021).Shigella is a rod-shaped gram-negative, non-motile, non-sporeforming bacteria that can cause shigellosis in humans. Ingestion of as little as 100 Shigella germs results in severe diarrhea within 4-7 days.When aggressive Shigella germs are swallowed, the bacterial infection invades the terminal ileum, epithelial lining, rectum, and colon, as well as the intestinal lining.…”

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confidence: 99%

Anti‐shigellosis activity of the aqueous extract of garlic, clove and fenugreek

Amer¹,

El-Rahman²

2022

Journal of Food Safety

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Shigellosis causes severe diarrhea and, in some cases, death in children. In this study, we investigated the in vitro and in vivo anti‐shigellosis efficacy of some aqueous herbal extracts or their chosen mixtures, including fenugreek seed, black seed, clove, garlic, and ginger. The antibacterial potential was assessed by well diffusion and microdilution assays. The extracts' minimum inhibitory concentrations ranged from 0.39 to 12.5 mg/ml. The water extract of garlic and combinations of garlic with either fenugreek or clove extracts had the highest antibacterial efficacy, hence these extracts were chosen for the in vivo investigation. Rats were given a Shigella dysenteriae inoculum and then administrated two doses (100 and 200 mg/kg bw) of the selected herbal extracts or the antibiotic ciprofloxacin (20 mg/kg bw) to treat Shigellosis in vivo. The results showed that garlic and clove extract mixtures (G6, 200 mg/kg bw), garlic and fenugreek mixtures (G7 and G8, 100 and 200 mg/kg bw), and ciprofloxacin group (G9, 20 mg/kg bw) had the best anti‐Shigellosis efficacy. G7 (garlic and fenugreek mixtures (100 mg/kg bw) outperformed almost all other groups evaluated. This group had lower defecation frequency, lower stool‐Shigella loudness, restored body weight, recovered hematological, and liver and kidney functions, besides exhibited no anatomical alterations in the colon tissue that were comparable to the uninfected group. As a result, in the treatment of Shigella, this extract combination may be suggested as a viable therapeutic alternative to antibiotics.

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Global diarrhoea-associated mortality estimates and models in children: Recommendations for dataset and study selection

Cited by 15 publications

References 16 publications

Evaluation of a simple, rapid and field-adapted diagnostic assay for enterotoxigenic E. coli and Shigella

Evaluation of a simple, rapid and field-adapted diagnostic assay for enterotoxigenic E. coli and Shigella

What Drives the Value of a Shigella Vaccine?

Anti‐shigellosis activity of the aqueous extract of garlic, clove and fenugreek

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