Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999–2000
From December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region. Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but hi...
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| Veröffentlicht in: | Transactions of the Royal Society of Tropical Medicine and Hygiene 2004-11, Vol.98 (11), p.635-643 |
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| container_title | Transactions of the Royal Society of Tropical Medicine and Hygiene |
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| creator | Guerin, P.J. Brasher, C. Baron, E. Mic, D. Grimont, F. Ryan, M. Aavitsland, P. Legros, D. |
| description | From December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region.
Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5–1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1–4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency. |
| doi_str_mv | 10.1016/j.trstmh.2004.01.005 |
| format | Article |
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Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5–1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1–4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.</description><identifier>ISSN: 0035-9203</identifier><identifier>EISSN: 1878-3503</identifier><identifier>DOI: 10.1016/j.trstmh.2004.01.005</identifier><identifier>PMID: 15363643</identifier><identifier>CODEN: TRSTAZ</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Animals ; Anti-Infective Agents - therapeutic use ; Antibiotic resistance ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Child ; Child, Preschool ; Ciprofloxacin ; Ciprofloxacin - therapeutic use ; Disease Outbreaks - prevention & control ; Drug Resistance ; Dysentery ; Dysentery, Bacillary - drug therapy ; Dysentery, Bacillary - epidemiology ; Dysentery, Bacillary - mortality ; Female ; Fluoroquinolones ; General aspects ; Human bacterial diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Serotyping ; Sex Distribution ; Shigella dysenteriae ; Shigella dysenteriae - classification ; Shigella dysenteriae - isolation & purification ; Sierra Leone ; Sierra Leone - epidemiology</subject><ispartof>Transactions of the Royal Society of Tropical Medicine and Hygiene, 2004-11, Vol.98 (11), p.635-643</ispartof><rights>2004 Royal Society of Tropical Medicine and Hygiene</rights><rights>Royal Society of Tropical Medicine and Hygiene 2004</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-bf3a12b5a179e9100caa9708912eceb871c90d9f4f1552aa9580fdb75f188cee3</citedby><cites>FETCH-LOGICAL-c468t-bf3a12b5a179e9100caa9708912eceb871c90d9f4f1552aa9580fdb75f188cee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16140687$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15363643$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guerin, P.J.</creatorcontrib><creatorcontrib>Brasher, C.</creatorcontrib><creatorcontrib>Baron, E.</creatorcontrib><creatorcontrib>Mic, D.</creatorcontrib><creatorcontrib>Grimont, F.</creatorcontrib><creatorcontrib>Ryan, M.</creatorcontrib><creatorcontrib>Aavitsland, P.</creatorcontrib><creatorcontrib>Legros, D.</creatorcontrib><title>Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999–2000</title><title>Transactions of the Royal Society of Tropical Medicine and Hygiene</title><addtitle>Trans R Soc Trop Med Hyg</addtitle><addtitle>Trans R Soc Trop Med Hyg</addtitle><description>From December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region.
Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5–1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1–4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Animals</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Antibiotic resistance</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Ciprofloxacin</subject><subject>Ciprofloxacin - therapeutic use</subject><subject>Disease Outbreaks - prevention & control</subject><subject>Drug Resistance</subject><subject>Dysentery</subject><subject>Dysentery, Bacillary - drug therapy</subject><subject>Dysentery, Bacillary - epidemiology</subject><subject>Dysentery, Bacillary - mortality</subject><subject>Female</subject><subject>Fluoroquinolones</subject><subject>General aspects</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Serotyping</subject><subject>Sex Distribution</subject><subject>Shigella dysenteriae</subject><subject>Shigella dysenteriae - classification</subject><subject>Shigella dysenteriae - isolation & purification</subject><subject>Sierra Leone</subject><subject>Sierra Leone - epidemiology</subject><issn>0035-9203</issn><issn>1878-3503</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQhiMEotvCGyDkC5yadCaOk_iCBCugSCtxKAjUi-U4k623m2SxHdS9IV6BN-RJ8CorekOcLHm-_5-Zf5LkGUKGgOXFJgvOh_4mywGKDDADEA-SBdZVnXIB_GGyAOAilTnwk-TU-w1ALlDIx8kJCl7ysuCL5OdSe2K9HvSaehoCGzumWT9tg23dtE4deeuDjoWrG7um7Vazdu8jSM5qYp7cGPY7YsjGKTSO9C2zQ3QwzkYhM2Mk78Lh78qSc5qtaBzonKGU8vePX3F2eJI86vTW09Pje5Z8fvf20_IyXX18_2H5epWaoqxD2nRcY94IjZUkiQBGa1lBLTEnQ01doZHQyq7oUIg81kQNXdtUosO6NkT8LHk5--7c-G0iH1RvvTmsNNA4eVWWdRWVZQSLGTRu9N5Rp3bO9trtFYI6ZK82as5eHbJXgCpmH2XPj_5T01N7LzqGHYEXR0B7o7ed04Ox_p4rsYA4Q-QuZm6cdv_bOp0V8VZ091ej3a0qK14Jdfn1Wr0B5AK_XKsD_2rmKeb9PR5GeWNpMNRaRyaodrT_bvgH0R3D7A</recordid><startdate>20041101</startdate><enddate>20041101</enddate><creator>Guerin, P.J.</creator><creator>Brasher, C.</creator><creator>Baron, E.</creator><creator>Mic, D.</creator><creator>Grimont, F.</creator><creator>Ryan, M.</creator><creator>Aavitsland, P.</creator><creator>Legros, D.</creator><general>Elsevier Ltd</general><general>Royal Society of Tropical Medicine and Hygiene</general><general>Elsevier</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041101</creationdate><title>Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999–2000</title><author>Guerin, P.J. ; 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Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5–1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1–4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>15363643</pmid><doi>10.1016/j.trstmh.2004.01.005</doi><tpages>9</tpages></addata></record> |
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| ispartof | Transactions of the Royal Society of Tropical Medicine and Hygiene, 2004-11, Vol.98 (11), p.635-643 |
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| subjects | Adolescent Adult Age Distribution Aged Aged, 80 and over Animals Anti-Infective Agents - therapeutic use Antibiotic resistance Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Child Child, Preschool Ciprofloxacin Ciprofloxacin - therapeutic use Disease Outbreaks - prevention & control Drug Resistance Dysentery Dysentery, Bacillary - drug therapy Dysentery, Bacillary - epidemiology Dysentery, Bacillary - mortality Female Fluoroquinolones General aspects Human bacterial diseases Humans Infectious diseases Male Medical sciences Middle Aged Serotyping Sex Distribution Shigella dysenteriae Shigella dysenteriae - classification Shigella dysenteriae - isolation & purification Sierra Leone Sierra Leone - epidemiology |
| title | Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999–2000 |
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