TY - JOUR
T1 - Spatiotemporal variation in risk of Shigella infection in childhood
T2 - a global risk mapping and prediction model using individual participant data
AU - Badr, Hamada S.
AU - Colston, Josh M.
AU - Nguyen, Nhat Lan H.
AU - Chen, Yen Ting
AU - Burnett, Eleanor
AU - Ali, Syed Asad
AU - Rayamajhi, Ajit
AU - Satter, Syed M.
AU - Van Trang, Nguyen
AU - Eibach, Daniel
AU - Krumkamp, Ralf
AU - May, Jürgen
AU - Adegnika, Ayola Akim
AU - Manouana, Gédéon Prince
AU - Kremsner, Peter Gottfried
AU - Chilengi, Roma
AU - Hatyoka, Luiza
AU - Debes, Amanda K.
AU - Ateudjieu, Jerome
AU - Faruque, Abu S.G.
AU - Hossain, M. Jahangir
AU - Kanungo, Suman
AU - Kotloff, Karen L.
AU - Mandomando, Inácio
AU - Nisar, M. Imran
AU - Omore, Richard
AU - Sow, Samba O.
AU - Zaidi, Anita K.M.
AU - Lambrecht, Nathalie
AU - Adu, Bright
AU - Page, Nicola
AU - Platts-Mills, James A.
AU - Mavacala Freitas, Cesar
AU - Pelkonen, Tuula
AU - Ashorn, Per
AU - Maleta, Kenneth
AU - Ahmed, Tahmeed
AU - Bessong, Pascal
AU - Bhutta, Zulfiqar A.
AU - Mason, Carl
AU - Mduma, Estomih
AU - Olortegui, Maribel P.
AU - Peñataro Yori, Pablo
AU - Lima, Aldo A.M.
AU - Kang, Gagandeep
AU - Humphrey, Jean
AU - Ntozini, Robert
AU - Prendergast, Andrew J.
AU - Okada, Kazuhisa
AU - Wongboot, Warawan
AU - Langeland, Nina
AU - Moyo, Sabrina J.
AU - Gaensbauer, James
AU - Melgar, Mario
AU - Freeman, Matthew
AU - Chard, Anna N.
AU - Thongpaseuth, Vonethalom
AU - Houpt, Eric
AU - Zaitchik, Benjamin F.
AU - Kosek, Margaret N.
N1 - Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2023/3
Y1 - 2023/3
N2 - Background: Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs). Methods: Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum. Findings: 20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76–0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76–0·88]). Interpretation: The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges–Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns. Funding: NASA, National Institutes of Health–The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.
AB - Background: Diarrhoeal disease is a leading cause of childhood illness and death globally, and Shigella is a major aetiological contributor for which a vaccine might soon be available. The primary objective of this study was to model the spatiotemporal variation in paediatric Shigella infection and map its predicted prevalence across low-income and middle-income countries (LMICs). Methods: Individual participant data for Shigella positivity in stool samples were sourced from multiple LMIC-based studies of children aged 59 months or younger. Covariates included household-level and participant-level factors ascertained by study investigators and environmental and hydrometeorological variables extracted from various data products at georeferenced child locations. Multivariate models were fitted and prevalence predictions obtained by syndrome and age stratum. Findings: 20 studies from 23 countries (including locations in Central America and South America, sub-Saharan Africa, and south and southeast Asia) contributed 66 563 sample results. Age, symptom status, and study design contributed most to model performance followed by temperature, wind speed, relative humidity, and soil moisture. Probability of Shigella infection exceeded 20% when both precipitation and soil moisture were above average and had a 43% peak in uncomplicated diarrhoea cases at 33°C temperatures, above which it decreased. Compared with unimproved sanitation, improved sanitation decreased the odds of Shigella infection by 19% (odds ratio [OR]=0·81 [95% CI 0·76–0·86]) and open defecation decreased them by 18% (OR=0·82 [0·76–0·88]). Interpretation: The distribution of Shigella is more sensitive to climatological factors, such as temperature, than previously recognised. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, although hotspots also occur in South America and Central America, the Ganges–Brahmaputra Delta, and the island of New Guinea. These findings can inform prioritisation of populations for future vaccine trials and campaigns. Funding: NASA, National Institutes of Health–The National Institute of Allergy and Infectious Diseases, and Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85148263028&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(22)00549-6
DO - 10.1016/S2214-109X(22)00549-6
M3 - Article
C2 - 36796984
AN - SCOPUS:85148263028
SN - 2214-109X
VL - 11
SP - e373-e384
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 3
ER -