INFECTION, DIARRHEA, AND DYSENTERY CAUSED BY SHIGELLA SPECIES AND CAMPYLOBACTER-JEJUNI AMONG GUATEMALAN RURAL CHILDREN

To examine the factors that may influence the outcome of infections by Shigella spp. and Campylobacter jejuni we followed for 24 consecutive months 321 rural Guatemala children 0 to 35 months old. Home visits w ere made to determine child morbidity patterns with emphasis on diarrh ea and dysentery. Fecal samples for microbiologic studies were obtaine d from the participants when they were ill and during healthy periods. Shigella spp. were isolated from 9.8 and 4.0% of ill and healthy chil dren, respectively; the figures for C. jejuni were 12.1% and 8.1%. Shi gella flexneri 1, 2 and 6 and Shigella sonnei accounted for 70% of all Shigella isolates. Twenty-four percent of Shigella spp. and 7% of C. jejuni infections resulted in dysentery. Shigella dysenteriae and Shig ella flexneri were more likely to induce dysentery than the other spec ies. The incidence of dysentery was 0.84 of 100 child weeks. Age, gend er, nutritional status and feeding habits of the children did not affe ct the outcome of Shigella infection. Fat consumption favored the deve lopment of dysentery caused by C. jejuni. The development of dysentery seems to be associated with microbial factors and not with host varia bles, although specific Shigella serotype protection against symptomat ic infection may be functional for prolonged periods after natural exp osure.