A cohort study to define the age-specific incidence and risk factors of Shigella diarrhoeal infections in Vietnamese children: a study protocol

BMC Public Health

Stephen Baker⁷  Cameron Simmons⁵  Guy Thwaites¹  James I Campbell¹  Nguyen Vinh Van Chau⁴  Nguyen Trong Hieu³  Nguyen Thi Van Thuy⁴  Lu Lan Vi⁴  Vu Thuy Duong²  Tran Thi Thao Ly²  Nguyen Thi Thanh Nhan²  Tran Do Hoang Nhu²  Le Thi Phuong Tu²  Pham Van Minh²  Ha Thanh Tuyen²  Le Thi Quynh Nhi²  Katherine L Anders⁶  Corinne N Thompson⁷ 

[1] Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK;Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam;Hung Vuong Hospital, Ho Chi Minh City, Vietnam;Hospital for Tropical Disease, Ho Chi Minh City, Vietnam;Department of Microbiology & Immunology, University of Melbourne, Melbourne, Australia;Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;The London School of Hygiene & Tropical Medicine, London, UK

关键词: Cohort;    Vietnam;    Active surveillance;    Shigella;    Diarrhoea;   

Others  :  1092115
DOI  :  10.1186/1471-2458-14-1289

 received in 2014-10-20, accepted in 2014-12-12,  发布年份 2014

【 摘 要 】

Background

Shigella spp. are one of the most common causes of paediatric dysentery globally, responsible for a substantial proportion of diarrhoeal disease morbidity and mortality, particularly in industrialising regions. Alarming levels of antimicrobial resistance are now reported in S. flexneri and S. sonnei, hampering treatment options. Little is known, however, about the burden of infection and disease due to Shigella spp. in the community.

Methods/Design

In order to estimate the incidence of this bacterial infection in the community in Ho Chi Minh City, Vietnam we have designed a longitudinal cohort to follow up approximately 700 children aged 12–60 months for two years with active and passive surveillance for diarrhoeal disease. Children will be seen at 6 month intervals for health checks where blood and stool samples will be collected. Families will also be contacted every two weeks for information on presence of diarrhoea in the child. Upon report of a diarrhoeal disease episode, study nurses will either travel to the family home to perform an evaluation or the family will attend a study hospital at a reduced cost, where a stool sample will also be collected. Case report forms collected at this time will detail information regarding disease history, risk factors and presence of disease in the household.

Outcomes will include (i) age-specific incidence of Shigella spp. and other agents of diarrhoeal disease in the community, (ii) risk factors for identified aetiologies, (iii) rates of seroconversion to a host of gastrointestinal pathogens in the first few years of life. Further work regarding the longitudinal immune response to a variety of Shigella antigens, host genetics and candidate vaccine/diagnostic proteins will also be conducted.

Discussion

This is the largest longitudinal cohort with active surveillance designed specifically to investigate Shigella infection and disease. The study is strengthened by the active surveillance component, which will likely capture a substantial proportion of episodes not normally identified through passive or hospital-based surveillance. It is hoped that information from this study will aid in the design and implementation of Shigella vaccine trials in the future.

【 授权许可】

   
2014 Thompson et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Thapar N, Sanderson IR: Diarrhoea in children: an interface between developing and developed countries. Lancet 2004, 363:641-653.
• [2]WHO: Diarrhoea: Why Children Are Still Dying and What Can Be Done. 2009.
• [3]Walker CLF, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, O’Brien KL, Campbell H, Black RE: Global burden of childhood pneumonia and diarrhoea. Lancet 2013, 381:1405-1416.
• [4]Kotloff K, Winickoff J, Ivanoff B, Clemens J, Swerdlow D, Sansonetti P, Adak G, Levine M: Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ 1999, 77:651-666.
• [5]Vinh H, Nhu NTK, Nga TVT, Duy PT, Campbell JI, Hoang NVM, Boni MF, My PVT, Parry C, Nga TTT, Van Minh P, Thuy CT, Diep TS, Phuong LT, Chinh MT, Loan HT, Tham NTH, Lanh MN, Mong BL, Anh VTC, Bay PVB, Chau NVV, Farrar J, Baker S: A changing picture of shigellosis in southern Vietnam: shifting species dominance, antimicrobial susceptibility and clinical presentation. BMC Infect Dis 2009, 9:204. BioMed Central Full Text
• [6]Meng CY, Smith BL, Bodhidatta L, Richard SA, Vansith K, Thy B, Srijan A, Serichantalergs O, Mason CJ: Etiology of Diarrhea in Young Children and Patterns of Antibiotic Resistance in Cambodia. Pediatr Infect Dis J 2011, 30:331-335.
• [7]Chompook P, Samosornsuk S, von Seidlein L, Jitsanguansuk S, Sirima N, Sudjai S, Mangjit P, Kim DR, Wheeler JG, Todd J, Lee H, Ali M, Clemens J, Tapchaisri P, Chaicumpa W: Estimating the burden of shigellosis in Thailand: 36-month population-based surveillance study. Bull World Health Organ 2005, 83:739-746.
• [8]Zafar A, Hasan R, Nizami SQ, von Seidlein L, Soofi S, Ahsan T, Chandio S, Habib A, Bhutto N, Siddiqui FJ, Rizvi A, Clemens JD, Bhutta ZA: Frequency of isolation of various subtypes and antimicrobial resistance of Shigella from urban slums of Karachi, Pakistan. Int J Infect Dis 2009, 13:668-672.
• [9]Ashkenazi S, Levy I, Kazaronovski V, Samra Z: Growing antimicrobial resistance of Shigella isolates. J Antimicrob Chemother 2003, 51:427-429.
• [10]Viñas MR, Tuduri E, Galar A, Yih K, Pichel M, Stelling J, Brengi SP, Della Gaspera A, van der Ploeg C, Bruno S, Rogé A, Caffer MI, Kulldorff M, Galas M: Laboratory-Based Prospective Surveillance for Community Outbreaks of Shigella spp. in Argentina. PLoS Negl Trop Dis 2013, 7:e2521.
• [11]Khatun F, Faruque A, Koeck J, Olliaro P, Millet P, Paris N, Malek M, Salam M, Luby S: Changing species distribution and antimicrobial susceptibility pattern of Shigella over a 29-year period (1980–2008). Epidemiol Infect 2011, 139:446-452.
• [12]Holt KE, Thieu Nga TV, Thanh DP, Vinh H, Kim DW, Vu Tra MP, Campbell JI, Hoang NVM, Vinh NT, Minh PV, Thuy CT, Nga TTT, Thompson C, Dung TTN, Nhu NTK, Vinh PV, Tuyet PTN, Phuc HL, Lien NTN, Phu BD, Ai NTT, Tien NM, Dong N, Parry CM, Hien TT, Farrar JJ, Parkhill J, Dougan G, Thomson NR, Baker S: Tracking the establishment of local endemic populations of an emergent enteric pathogen. Proc Natl Acad Sci 2013, 201308632:1-6.
• [13]Vrints M, Mairiaux E, Van Meervenne E, Collard J-M, Bertrand S: Surveillance of antibiotic susceptibility patterns among Shigella sonnei strains isolated in Belgium during the 18-year period 1990 to 2007. J Clin Microbiol 2009, 47:1379-1385.
• [14]Toro CS, Farfán M, Contreras I, Flores O, Navarro N, Mora GC, Prado V: Genetic analysis of antibiotic-resistance determinants in multidrug-resistant Shigella strains isolated from Chilean children. Epidemiol Infect 2005, 133:81-86.
• [15]Wang X, Tao F, Xiao D, Lee H, Deen J, Gong J, Zhao Y, Zhou W, Li W, Shen B, Song Y, Ma J, Li Z, Wang Z, Su P, Chang N, Xu J, Ouyang P, von Seidlein L, Xu Z, Clemens JD: Trend and disease burden of bacillary dysentery in China (1991–2000). Bull World Health Organ 2006, 84:561-568.
• [16]Replogle M, Fleming D, Cieslak P: Emergence of antimicrobial-resistant shigellosis in Oregon. Clin Infect Dis 2000, 30:515-519.
• [17]Statistical Yearbook of Ho Chi Minh City 2011. Ho Chi Minh City: Ho Chi Minh City Statistical Office; 2012.
• [18]Kelly-Hope LA, Alonso WJ, Thiem VD, Canh DG, Anh DD, Lee H, Miller MA: Enteric Diseases in Vietnam, 1991–2001. Environ Health Perspect 2008, 116:7-12.
• [19]Von Seidlein L, Kim DR, Ali M, Lee H, Wang X, Thiem VD, Canh DG, Chaicumpa W, Agtini MD, Hossain A, Bhutta ZA, Mason C, Sethabutr O, Talukder K, Nair GB, Deen JL, Kotloff K, Clemens J: A multicentre study of Shigella diarrhoea in six Asian countries: disease burden, clinical manifestations, and microbiology. PLoS Med 2006, 3:e353.
• [20]Isenbarger DW, Hien BT, Ha HT, Ha TT, Bodhidatta L, Pang LW, Cam PD: Prospective study of the incidence of diarrhoea and prevalence of bacterial pathogens in a cohort of Vietnamese children along the Red River. Epidemiol Infect 2001, 127:229-236.
• [21]Sripaipan T, Schroeder DG, Marsh DR, Pachón H, Dearden KA, Ha TT, Lang TT: Effect of an integrated nutrition program on child morbidity due to respiratory infection and diarrhea in northern Viet Nam. Food Nutr Bull 2002, 23:67-74.
• [22]Brown J, Sobsey MD, Loomis D: Local Drinking Water Filters Reduce Diarrheal Disease in Cambodia: A Randomized, Controlled Trial of the Ceramic Water Purifier. Am J Trop Med Hyg 2008, 79:394-400.
• [23]Sima LC, Desai MM, Mccarty KM, Elimelech M: Relationship between Use of Water from Community-Scale Water Treatment Refill Kiosks and Childhood Diarrhea in Jakarta. Am J Trop Med Hyg 2012, 87:979-984.
• [24]Anders KL, Nguyen NM, Van Thuy NT, Hieu NT, Nguyen HL, Thi N, Tham H, Thi P, Ha T, Lien LB, Chau NVV, Simmons CP: A birth cohort study of viral infections in Vietnamese infants and children: study design, methods and characteristics of the cohort. BMC Public Health 2013, 13:937-946. BioMed Central Full Text
• [25]World Health Organization: Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers. Geneva; 2005.
• [26]Allen S, Martinez E, Gregorio G, Dans L: Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev 2010, 10:CD003048.
• [27]Lazzerini M, Ronfani L: Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev 2013, 31:CD005436.
• [28]Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobials Disk Susceptibility Test. Wayne, PA; 2006.
• [29]Dung TTN, Phat VV, Nga TVT, My PVT, Duy PT, Campbell JI, Thuy CT, Hoang NVM, Van Minh P, Le Phuc H, Tuyet PTN, Vinh H, Kien DTH, Huy HLA, Vinh NT, Nga TTT, Hau NTT, Chinh NT, Thuong TC, Tuan HM, Simmons C, Farrar JJ, Baker S: The validation and utility of a quantitative one-step multiplex RT real-time PCR targeting rotavirus A and norovirus. J Virol Methods 2013, 187:138-143.
• [30]Cohen D, Block C, Green M, Lowell G, Ofek I: Immunoglobulin M, A, and G antibody response to lipopolysaccharide O antigen in symptomatic and asymptomatic Shigella infections. J Clin Microbiol 1989, 27:162-167.
• [31]Schmidt W-P, Arnold BF, Boisson S, Genser B, Luby SP, Barreto ML, Clasen T, Cairncross S: Epidemiological methods in diarrhoea studies–an update. Int J Epidemiol 2011, 40:1678-1692.
• [32]Metzger KB, Hajat A, Crawford M, Mostashari F: How many illnesses does one emergency department visit represent? Using a population-based telephone survey to estimate the syndromic multiplier. Morb Mortal Wkly Rep 2004, 53(Suppl):106-111.
• [33]Cohen D, Green MS, Block C, Rouach T, Ofek I: Serum Antibodies to Lipopolysaccharide and Natural Immunity to Shigellosis in an Israli Military Population. J Infect Dis 1988, 157:1068-1071.
• [34]Formal S, Oaks E, Olsen R, Wingfield-Eggleston M, Snoy P, Cogan J: Effect of prior infection with virulent Shigella flexneri 2a on the resistance of monkeys to subsequent infection with Shigella sonnei. J Infect Dis 1991, 164:533-537.
• [35]Ferreccio C, Prado V, Ojeda A, Cayyazo M, Abrego P, Guers L, Levine M: Epidemiologic patterns of acute diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile. Am J Epidemiol 1991, 134:614-627.
• [36]Levine MM, Kotloff KL, Barry EM, Pasetti MF, Sztein MB: Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road. Nat Rev Microbiol 2007, 5:540-553.
• [37]Lee S-J, Liang L, Juarez S, Nanton MR, Gondwe EN, Msefula CL, Kayala MA, Necchi F, Heath JN, Hart P, Tsolis RM, Heyderman RS, MacLennan CA, Felgner PL, Davies DH, McSorley SJ: Identification of a common immune signature in murine and human systemic Salmonellosis. Proc Natl Acad Sci 2012, 109:4998-5003.
• [38]Cannella AP, Lin JC, Liang L, Atluri V, Gotuzzo E, Felgner PL, Tsolis RM, Vinetz JM: Serial Kinetics of the Antibody Response against the Complete Brucella melitensis ORFeome in Focal Vertebral Brucellosis. J Clin Microbiol 2012, 50:922-926.