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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3181cb4608
Original Studies

Characteristics of Children With Shigella Encephalopathy: Experience From a Large Urban Diarrhea Treatment Center in Bangladesh

Chisti, Mohammod Jobayer MB BS*; Faruque, Abu Syed Golam MPH*; Khan, Wasif Ali MD*; Das, Sumon Kumar MB BS*; Zabed, Mir Borhan MPharm†; Salam, Mohammed Abdus MB BS*

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Abstract

Background: Encephalopathy is a serious neurologic complication from shigellosis often with fatal outcome but data on simple clinical and sociodemographic predicting factors are limited. We sought to identify those factors in children.

Methods: In this unmatched case-control design, children of both sexes, aged 0 to 15 years having positive stool culture for Shigella from 1997 to 2006 were studied. Children with Shigella encephalopathy constituted the cases (n = 29), whereas randomly selected children with shigellosis having no encephalopathy constituted controls (n = 87).

Results: The case-fatality was significantly higher among the cases than among controls (7% vs. 0%, RR: 4.2, CI: 3.0–5.9, P = 0.013). In logistic regression analysis, children with Shigella encephalopathy more often had an illiterate father (OR: 5.4, 95% CI: 1.1–27.1, P = 0.038), stopped breast-feeding in the neonatal period (OR: 41.3, 95% CI: 4.2–403.1, P = 0.001), had dehydrating diarrhea (OR: 9.9, 95% CI: 2.1–45.9, P = 0.004) with a duration of <1 day (OR: 29.4, 95% CI: 2.1–43.2, P = 0.004), and were more likely to be severely stunted (OR: 6.4, 95% CI: 1.2–34.9, P = 0.033).

Conclusion: Education of parents about the value of exclusive breast-feeding and of prompt hydration in children with Shigella is critical to minimize morbidity and deaths.

© 2010 Lippincott Williams & Wilkins, Inc.

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