Shigellosis among Breastfed Children: A Facility Based Observational Study in Rural Bangladesh | OMICS International | Abstract
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
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Research Article

Shigellosis among Breastfed Children: A Facility Based Observational Study in Rural Bangladesh

Shahnawaz Ahmed1*, Farzana Ferdous1, Jui Das1, Fahmida Dil Farzana1, Mohammod Jobayer Chisti1, Jonathan R Latham3, Sumon Kumar Das2, Abdullah Al Mamun2 and Abu Syed GolamFaruque1

1International Centre for Diarrhoeal Disease Research, Bangladesh

2School of Public Health, The University of Queensland, Brisbane, Australia

3London School of Hygiene and Tropical Medicine, London, UK

*Corresponding Author:
Shahnawaz Ahmed
Centre for Nutrition and Food Security (CNFS)
International Centre for Diarrhoeal Disease Research
Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Sarani
Mohakhali, Dhaka 1212, Bangladesh
Tel: +880-2-9827104
Fax: +880-2-9827104
E-mail: [email protected]

Received date: August 12, 2015 Accepted date: August 25, 2015 Published date: August 31, 2015

Citation: Ahmed S, Ferdous F, Das J, Farzana FD, Chisti MJ, et al. (2015) Shigellosis among Breastfed Children: A Facility Based Observational Study in Rural Bangladesh. J Gastrointest Dig Syst 5:327. doi:10.4172/2161-069X.1000327

Copyright: © 2015 Ahmed S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.


Objective: Although breastfed children are less likely to suffer from infectious diarrhea, children under 2 years of age are often infected with Shigella. The study aimed to understand socio-demographic, clinical, and host characteristics of breastfed children under 2 years of age with shigellosis and compare these factors with breastfed children who presented with non-Shigella associated diarrhea in rural Mirzapur, Bangladesh. Methods: From January 2010 to December 2012, a total of 3,409 children under 5 years with diarrhea were admitted to a tertiary level hospital in rural Bangladesh with diarrhea. A total of 2,278 (67%) of these children were aged 0-23 months and had reported history of breastfeeding and were enrolled in the study. Nine percent (n=205, 9%) of the enrolled children were infected with Shigella and were thus considered to be cases and the remaining children (n=2,073, 91%) were not infected with Shigella and formed the comparison group. Results: Breastfed children with shigellosis were more likely to be underweight (<–2 weight-for-age z-score) [(31% vs. 18%; p<0.001)], stunted (<–2 height-for-age z-score) [(22% vs. 13%; p<0.001)] and wasted (<–2 weightfor- height z-score) [(22% vs. 13%; p<0.001)] compared to breastfed children without shigellosis. Rotavirus (14% vs. 29%, <0.001) was detected less commonly as a co-pathogen amongst children with shigellosis relative to their counterparts. In multivariate analysis, significant associations with shigellosis were observed with child age (12-23 months) [OR: 3.02 (95% CI-2.17-4.18)], blood in stool [OR: 6.44 (4.68-8.88)], fever [OR: 1.95 (1.41-2.68)], convulsion [OR: 2.80 (1.04-7.54)], stunting [OR: 1.53 (1.03-2.28)], and use of zinc at home [OR: 0.67 (0.46-0.98)] after controlling for other covariates. Conclusion: Breastfed children with shigellosis were more likely to be malnourished than those who were also breastfed but not infected with Shigella among rural Bangladeshi children under 2 years of age.


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