SHIGELLOSIS IN CHILDREN - A CLINICO-EPIDEMIOLOGIC COMPARISON BETWEEN SHIGELLA-DYSENTERIAE TYPE-I AND SHIGELLA-FLEXNERI

We reviewed the clinical and epidemiological features of 390 children under 5 years of age infected with either Shigella dysenteriae type I or Shigella flexneri attending a diarrhoea treatment centre from 1993 to 1995 in Dhaka, Bangladesh. Older age (24 months or more), underweig ht and wasting but not stunting were the host factors significantly mo re associated with Shigella dysenteriae type I infection than in Shige lla flexneri-infected children. Moreover, use of antibiotics at home, use of water from tubewells or pipe-water for drinking and lack of san itary facilities for defaecation were the behavioural and environmenta l factors strongly associated with S. dysenteriae type I infection. Ch ildren with diarrhoea due to S. flexneri presented with more watery/li quid stools and had a shorter duration of illness. Duration of diarrho ea for 4 or more days was typical of S. dysenteriae type I infection. Interventions to address malnutrition and to promote environmental hyg iene would be predicted to offer greater protection against shigellosi s due to S. dysenteriae than S. flexneri.