Table 4.
Studies of case-fatality rates associated with specific Shigella species
| Enrolment dates | Population and study characteristics |
Shigella dysenteriae type 1 |
Other S dysenteriae |
Shigella flexneri |
Shigella sonnei |
Shigella boydii |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n/N | Case fatality (95% CI) | n/N | Case fatality (95% CI) | n/N | Case fatality (95% CI) | n/N | Case fatality (95% CI) | n/N | Case fatality (95% CI) | |||
| Bennish et al (1990)10 | 1974–88 | Inpatients of all ages with diarrhoea and culture-confirmed Shigella spp; study done in Bangladesh; deaths ascertained during hospital admission for presenting diarrhoea | 2221/9780 | 6·7% (5·3–7·8) | 374/9780 | 8·2% (5·5–11·3) | 6001/9780 | 10% (9·3–10·8) | 445/9780 | 10·3% (7·7–13·5) | 739/9780 | 8·4% (6·4–10·5) |
| Khan et al (2013)6 | 1987–89 | Inpatients aged <15 years with diarrhoea and culture-confirmed Shigella spp; study done in Bangladesh; deaths ascertained during hospital admission for presenting diarrhoea | 157/792 | 10·8% (6·4–16·8) | 24/792 | 4·2% (0·1–21·1) | 504/792 | 10·5% (8·0–13·5) | 30/792 | 13·3% (3·8–30·7) | 77/792 | 10·4% (0·1–19·0) |
| O'Reilly et al (2012)3 | 2005–07 | Inpatients aged <5 years with watery, mucoid, or bloody diarrhoea; study done in Kenya; dysentery defined as visible bloody stool; Shigella spp detected by culture; deaths ascertained during hospital admission for presenting diarrhoea | .. | .. | 4/42 | 50·0% (6·8–93·2) | 30/42 | 23·3% (13·2–52·9) | 6/42 | 16·7% (0·4–64·1) | 2/42 | 100% (15·8–100) |
| van den Broek et al (2005)21 | 1993–99 | Severely malnourished inpatients* aged <4 years with diarrhoea; study done in Bangladesh; unclear definition of dysentery; Shigella spp detected by culture; deaths ascertained during hospital admission for presenting diarrhoea | 38/200 | 47·3% (31·0–64·2) | .. | .. | 162/200 | 50·6% (42·6–58·6) | .. | .. | .. | .. |
| de Widerspach-Thor et al (2002)65 | 1996–97 | All inpatients had culture-confirmed Shigella spp; study done in Djibouti; deaths ascertained during hospital admission for presenting diarrhoea | 6/42† | 16·7% (0·4–64·1)† | 6/42† | 16·7% (0·4–64·1)† | 29/42 | 6·9% (0·8–22·8) | 5/42 | 0% (0–52·2) | 2/42 | 50·0% (12·6–98·7) |
| Zaman et al (1991)66 | 1978–87 | All admissions had culture-confirmed Shigella spp; study done in Bangladesh; deaths ascertained during hospital admission for presenting diarrhoea | 935/3440 | 0·9% (0·4–1·7) | .. | .. | 1834/3440 | 1·1% (0·7–1·7) | .. | .. | .. | .. |
Data are Shigella species (n)/total Shigella species (N). The appendix (p 2) summarises the associated GRADE quality assessment. 98 cases of other S dysenteriae, 194 S sonnei, and 379 S boydii are reported; however, no case-fatality rates are given for these serotypes in Zaman et al (1991).66 GRADE=Grading of Recommendations Assessment, Development and Evaluation. WAZ=weight-for-age Z score.
*
Severe malnutrition was defined using Gomez classification WAZ <60% of National Center for Health Statistics median.
†
All S dysenteriae cases combined.