Part II. Analysis of data gaps pertaining toShigellainfections in low and medium human development index countries, 1984–2005

Abstract

SUMMARYThe global incidence ofShigellainfection has been estimated at 80–165 million episodes annually, with 99% of episodes occurring in the developing world. To identify contemporary gaps in the understanding of the global epidemiology of shigellosis, we conducted a review of the English-language scientific literature from 1984 to 2005, restricting the search to low and medium human development countries. Our review yielded 11 population-based studies ofShigellaburden from seven countries. No population-based studies have been conducted in sub-Saharan Africa or in low human development countries. In studies done in all age groups,Shigellaincidence varied from 0·6 to 107 episodes/1000 person-years.S. flexneriwas the most commonly detected subgroup in the majority of studies. Case-fatality rates ranged from 0% to 2·6% in population-based studies and from 0% to 21% in facility-based studies. This review highlights the large gaps in data on the burden ofShigellainfections for low human development index countries and, more specifically, for sub-Saharan Africa.