EPIDEMIC DYSENTERY IN WESTERN KENYA

This paper describes the epidemiology of a probable Shigella dysenteri ae type 1 dysentery epidemic in western Kenya. A retrospective record review over 2 years of all cases of dysentery, amoebiasis and diarrhoe a was carried out in 13 healthcare facilities in the Rarieda Division of Nyanza province. Of the 3301 cases recorded, 2191 were dysentery, g iving a cumulative 2 years incidence rate for dysentery of 4%. The epi demic began in December 1994 and peaked in February 1995, coinciding w ith the very dry season. One location in the area had an overall attac k rate of 9.3%, double that of other locations. Highest rates were in children aged <5 years and in persons >15 years old. S. dysenteriae ty pe 1, with its increasing multi-antibiotic resistance, is a continuing threat to the health of people in this region; this area may be suita ble for intensive, prospective surveillance as a prelude to a Shigella vaccine trial.