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Life sciences · Journal article
PLOS Neglected Tropical Diseases · August 14, 2026
Encouraging direction, but not yet definitive.
This prospective community cohort study from peri-urban Burkina Faso documents Shigella incidence of 6.8 per 1,000 child-months (95% CI 5.3–8.9) in children under five, with S. flexneri predominating (58.9%), and identifies young age (12–47 months) as a significant risk factor while public water source use was protective. The findings provide local epidemiologic data to inform vaccine development and targeted interventions but are restricted to a single geographic setting.
Community-based prospective longitudinal cohort study. Children under five years of age living in a peri-urban area of Ouagadougou, Burkina Faso; 750 enrolled.. Intervention: Active and passive surveillance for Shigella infection (symptomatic and asymptomatic); microbiological analysis of stool samples.. n = 750. Peri-urban area of Ouagadougou, Burkina Faso; single site..
Shigella incidence of 6.8 per 1,000 child-months (95% CI: 5.3–8.9) among 56 incident cases over 12 months S. flexneri predominated at 58.9%, followed by S. boydii (23.2%), S. sonnei (14.3%), and S. dysenteriae (3.6%) Incidence among diarrheal cases was 39.2 per 1,000 child-months (95% CI: 24.7–62.2), with substantial asymptomatic carriage at 4.9 per 1,000 child-months
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Clinicians and public health planners in low-resource settings should consider these local Shigella burden and serotype data when evaluating vaccine introduction strategies and targeting water, sanitation, and hygiene interventions. The identification of age-specific risk and protective factors can inform risk stratification and preventive messaging to caregivers.
A well-designed 12-month community cohort study with active and passive surveillance in a priority low-resource setting, providing incidence rates and risk factors for Shigella in children under five, but limited to a single peri-urban location and primarily descriptive rather than intervention-based.
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Quoted from the source exactly as published.
Clinicians and public health planners in low-resource settings should consider these local Shigella burden and serotype data when evaluating vaccine introduction strategies and targeting water, sanitation, and hygiene interventions. The identification of age-specific risk and protective factors can inform risk stratification and preventive messaging to caregivers.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Shigella is a leading cause of childhood diarrheal disease and a priority target for vaccine development, particularly in low-resource settings where its true burden is often underestimated. A clear understanding of local Shigella epidemiology and risk factors is essential for guiding control strategies and vaccine introduction. Methodology/Principal Findings We conducted a 12-month longitudinal cohort study enrolling 750 children under five years of age in a peri-urban area of Ouagadougou, Burkina Faso, from December 2020 to March 2021, with follow-up through March 2022. Active and passive surveillance captured both symptomatic and asymptomatic infections. Stool samples (n = 2,401), including 236 from diarrheal episodes, were analyzed by conventional microbiological methods with species confirmation using the BD Phoenix M50 system. Shigella was isolated from 56 incident cases, yielding an incidence rate of 6.8 cases per 1,000 child-months (95% CI: 5.3-8.9). Shigella flexneri predominated (58.9%), followed by S. boydii (23.2%), S. sonnei (14.3%), and S. dysenteriae (3.6%). Incidence among diarrheal cases was 39.2 per 1,000 child-months (95% CI: 24.7-62.2), alongside substantial asymptomatic carriage (4.9 per 1,000 child-months). Shigellosis was strongly associated with diarrhea, predominantly mucoid rather than bloody stools. Young age was a significant predictor, particularly at 12–23 months (aHR = 2.68; 95% CI: 1.11-6.47) and 36–47 months (aHR = 2.81; 95% CI: 1.08-7.33), while use of a public water source was independently protective (aHR = 0.52; 95% CI: 0.29-0.94). Conclusions/Significance This study provides foundational incidence and serotype data for Shigella among young children in peri-urban Burkina Faso, informing future vaccine development and targeted public health interventions. The findings highlight the need to strengthen water, sanitation, and hygiene programs, improve diagnostic capacity, and enhance antimicrobial resistance surveillance to reduce Shigella transmission and impact in this population.
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