The Lancet Global Health (Mar 2023)
Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data
- Hamada S Badr, PhD,
- Josh M Colston, PhD,
- Nhat-Lan H Nguyen, BA,
- Yen Ting Chen, MD,
- Eleanor Burnett, MPH,
- Syed Asad Ali, MPH,
- Ajit Rayamajhi, MD,
- Syed M Satter, MPH,
- Nguyen Van Trang, PhD,
- Daniel Eibach, PD,
- Ralf Krumkamp, DrPH,
- Jürgen May, MD,
- Ayola Akim Adegnika, PhD,
- Gédéon Prince Manouana, PhD,
- Peter Gottfried Kremsner, MD,
- Roma Chilengi, MSc,
- Luiza Hatyoka, PhD,
- Amanda K Debes, PhD,
- Jerome Ateudjieu, PhD,
- Abu S G Faruque, MPH,
- M Jahangir Hossain, MSc,
- Suman Kanungo, PhD,
- Karen L Kotloff, MD,
- Inácio Mandomando, PhD,
- M Imran Nisar, PhD,
- Richard Omore, PhD,
- Samba O Sow, MSc,
- Anita K M Zaidi, SM,
- Nathalie Lambrecht, PhD,
- Bright Adu, PhD,
- Nicola Page, MPH,
- James A Platts-Mills, MD,
- Cesar Mavacala Freitas, MD,
- Tuula Pelkonen, PhD,
- Per Ashorn, PhD,
- Kenneth Maleta, PhD,
- Tahmeed Ahmed, PhD,
- Pascal Bessong, PhD,
- Zulfiqar A Bhutta, PhD,
- Carl Mason, MD,
- Estomih Mduma, PhD,
- Maribel P Olortegui, MPH,
- Pablo Peñataro Yori, MPH,
- Aldo A M Lima, PhD,
- Gagandeep Kang, PhD,
- Jean Humphrey, ScD,
- Robert Ntozini, MPH,
- Andrew J Prendergast, DPhil,
- Kazuhisa Okada, PhD,
- Warawan Wongboot, PhD,
- Nina Langeland, PhD,
- Sabrina J Moyo, PhD,
- James Gaensbauer, MD,
- Mario Melgar, MD,
- Matthew Freeman, PhD,
- Anna N Chard, MPH,
- Vonethalom Thongpaseuth, MD,
- Eric Houpt, MD,
- Benjamin F Zaitchik, PhD,
- Margaret N Kosek, MD
Affiliations
- Hamada S Badr, PhD
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA
- Josh M Colston, PhD
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
- Nhat-Lan H Nguyen, BA
- College of Arts and Sciences, University of Virginia, VI, USA
- Yen Ting Chen, MD
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
- Eleanor Burnett, MPH
- Division of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
- Syed Asad Ali, MPH
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Ajit Rayamajhi, MD
- Department of Pediatrics, National Academy of Medical Sciences, Kanti Children's Hospital, Kathmandu, Nepal
- Syed M Satter, MPH
- Programme for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Nguyen Van Trang, PhD
- National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
- Daniel Eibach, PD
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Ralf Krumkamp, DrPH
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Jürgen May, MD
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Ayola Akim Adegnika, PhD
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
- Gédéon Prince Manouana, PhD
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
- Peter Gottfried Kremsner, MD
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
- Roma Chilengi, MSc
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Luiza Hatyoka, PhD
- Enteric diseases and Vaccines Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Amanda K Debes, PhD
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Jerome Ateudjieu, PhD
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon; Department of Health Research, M A SANTE (Meileur Acces aux Soins en Santé), Yaoundé, Cameroon; Division of Health Operations Research, Cameroon Ministry of Public Health, Yaoundé, Cameroon
- Abu S G Faruque, MPH
- Centre for Nutrition & Food Security, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- M Jahangir Hossain, MSc
- Medical Research Council Unit, The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
- Suman Kanungo, PhD
- National Institute of Cholera and Enteric Diseases, Kolkota, India
- Karen L Kotloff, MD
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- Inácio Mandomando, PhD
- Centro de Investigação em Saúde de Manhiça, Manhica, Mozambique
- M Imran Nisar, PhD
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Richard Omore, PhD
- Kenya Medical Research Institute, Center for Global Health Research, Kisumu, Nyanza, Kenya
- Samba O Sow, MSc
- Centre pour le Développement des Vaccins, Mali, Bamako, Mali
- Anita K M Zaidi, SM
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Nathalie Lambrecht, PhD
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Bright Adu, PhD
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Nicola Page, MPH
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Pretoria, South Africa
- James A Platts-Mills, MD
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
- Cesar Mavacala Freitas, MD
- Hospital Pediátrico David Bernardino, Luanda, Angola
- Tuula Pelkonen, PhD
- New Children's Hospital, Pediatric Research Center and Helsinki University Hospital, Helsinki, Finland
- Per Ashorn, PhD
- Centre for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Kenneth Maleta, PhD
- College of Medicine, University of Malawi, Blantyre, Malawi
- Tahmeed Ahmed, PhD
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Pascal Bessong, PhD
- HIV/AIDS & Global Health Research Programme, University of Venda, Thohoyandou, Limpopo, South Africa
- Zulfiqar A Bhutta, PhD
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
- Carl Mason, MD
- Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
- Estomih Mduma, PhD
- Haydom Global Health Institute, Haydom, Tanzania
- Maribel P Olortegui, MPH
- Asociacion Benefica PRISMA, Iquitos, Peru
- Pablo Peñataro Yori, MPH
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
- Aldo A M Lima, PhD
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Gagandeep Kang, PhD
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India
- Jean Humphrey, ScD
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Robert Ntozini, MPH
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
- Andrew J Prendergast, DPhil
- Blizard Institute, Queen Mary University of London, London, UK
- Kazuhisa Okada, PhD
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Warawan Wongboot, PhD
- Department of Medical Sciences, National Institute of Health, Nonthaburi, Thailand
- Nina Langeland, PhD
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Sabrina J Moyo, PhD
- Department of Clinical Science, University of Bergen, Bergen, Norway
- James Gaensbauer, MD
- Center for Global Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
- Mario Melgar, MD
- Pediatric Infectious Diseases, Hospital Roosevelt, Guatemala City, Guatemala
- Matthew Freeman, PhD
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA
- Anna N Chard, MPH
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, 30322, GA, USA
- Vonethalom Thongpaseuth, MD
- Laboratory and Treatment Unit, Center for Malariology, Parasitology, and Entomology, Ministry of Health, Vientiane, Lao PDR
- Eric Houpt, MD
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
- Benjamin F Zaitchik, PhD
- Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, MA, USA; Correspondence to: Dr Benjamin F Zaitchik, Department of Earth and Planetary Sciences, Johns Hopkins Krieger School of Arts and Sciences, Baltimore, 21218, MA, USA
- Margaret N Kosek, MD
- Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, VA, USA
- Journal volume & issue
-
Vol. 11,
no. 3
pp. e373 – e384
Abstract
Summary: 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.
