Shigellosis remains an important problem in children less than 5 years of age in Thailand

Abstract

SUMMARYThis is a review of existing data on the burden of shigellosis in Thailand to determine trends, vulnerable groups, predominant species and serotypes, and antimicrobial resistance patterns. Diarrhoea and dysentery morbidity and mortality data from 1991 to 1999 was collected from the routine surveillance system and demographic data from the government census. International and local literature published between 1988 and 2000 was systematically reviewed. Based on the routine surveillance system, the annual incidence of bacillary dysentery decreased from 1 . 3 to 0 . 2/10 000 persons per year. The remaining burden is highest in children <5 years of age at 2 . 7/10 000 persons per year. In comparison, a prospective study utilizing active surveillance found an incidence in children <5 years of age that was more than 100-fold higher at 640/10 000 persons per year. Despite the decrease in morbidity and mortality based on routinely collected data, shigellosis remains an important problem in children <5 years of age in Thailand.

A Cost Function Analysis of Shigellosis in Thailand

“…Information on treatment cost from this study and previous epidemiological studies, including further estimation of vaccine delivery cost, can be used in a modeling design of cost‐effectiveness analysis (CEA) [44] for a shigella vaccine. The analysis can be performed for all age groups or high‐risk groups whose age are less than 5 years old [5]. The fitted model provided an estimated cost of treatment at various settings.…”

“…The disease is an alarming problem in children aged less than 5 years. Based on an active surveillance of this particular age group, the incidence rate was 64 cases per 1000 population per year [5]. It is noteworthy to mention that though several international studies have been published on the economic aspects of enteric infections [6–11], no similar research has been published from Thailand.…”

Convergent Evolution in the Assembly of Polyubiquitin Degradation Signals by the Shigella flexneri IpaH9.8 Ligase

“…Only members of the Ubc5 family supported robust 125 I-polyubiquitin chain formation, with the resulting conjugates accumulating at the top of the resolving and stacker gels (Fig. 1A, lanes [3][4][5]. Because the assays are conducted under initial velocity conditions, the autoradiographic intensity is proportional to the initial rate; thus, the increased intensity of the signal with Ubc5B and Ubc5C compared with Ubc5A indicates that IpaH9.8 can distinguish among these otherwise highly conserved Ubc5 isozymes.…”

“…Gastrointestinal infection with the genus Shigella alone is responsible for over 1.1 million deaths annually and disproportionately affects children under the age of five (3). Additionally, prior infection with Shigella has also been implicated in the etiology of persistent reactive arthritis and hemolytic-uremic syndrome (4).…”

“…The exact biochemical mechanism for inhibition of NF-B signaling remained unclear until Rhode et al (20) showed that IpaH9.8 (and presumably all IpaH paralogs) possesses intrinsic ubiquitin ligase activity localized to the conserved C-terminal domain. Because these enzymes contain an active site cysteine residue essential for E3 ligase function, the IpaH family has been termed HECT 3 -like, referring to the conserved HECT family of eukaryotic enzymes that also possess an active site cysteine (21). However, the primary sequences of the IpaH catalytic domains are unrelated to those of the eukaryotic HECT ligase superfamily or to the larger class of RING ligases (17,20,22).…”