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-
1
Guerrant RL, Hughes JM, Lima NL, Crane J, 1990. Diarrhea in developed and developing countries: magnitude, special settings, and etiologies. Rev Infect Dis 12 (Suppl 1):S41–S50.
-
2
Juckett G, 1999. Prevention and treatment of traveler’s diarrhea. Am Fam Physician 60 :119–124, 135–136.
-
3
Shlim DR, Hoge CW, Rajah R, Scott RM, Pandy P, Echeverria P, 1999. Persistent high risk of diarrhea among foreigners in Nepal during the first 2 years of residence. Clin Infect Dis 29 :613–616.
-
4
Kotloff KL, Winickoff JP, Ivanoff B, Clemens JD, Swerdlow DL, Sansonetti PJ, Adak GK, Levine MM, 1999. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ 77 :651–666.
-
5
Mohle-Boetani JC, Stapleton M, Finger R, Bean NH, Poundstone J, Blake PA, Griffin PM, 1995. Communitywide shigellosis: control of an outbreak and risk factors in child day-care centers. Am J Public Health 85 :812–816.
-
6
Hoffman RE, Shillam PJ, 1990. The use of hygiene, cohorting, and antimicrobial therapy to control an outbreak of shigellosis. Am J Dis Child 144 :219–221.
-
7
Pickering LK, Evans DG, DuPont HL, Vollet JJ 3rd, Evans DJ Jr, 1981. Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study. J Pediatr 99 :51–56.
-
8
Baer JT, Vugia DJ, Reingold AL, Aragon T, Angulo FJ, Bradford WZ, 1999. HIV infection as a risk factor for shigellosis. Emerg Infect Dis 5 :820–823.
-
9
Germani Y, Minssart P, Vohito M, Yassibanda S, Glaziou P, Hocquet D, Berthelemy P, Morvan J, 1998. Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. Am J Trop Med Hyg 59 :1008–1014.
-
10
Angulo FJ, Swerdlow DL, 1995. Bacterial enteric infections in persons infected with human immunodeficiency virus. Clin Infect Dis 21 (Suppl 1):S84–S93.
-
11
van Oosterhout JJ, van der Hoek W, 1994. Infection with HIV, a risk factor for epidemic dysentery? A case-control study from Zambia. AIDS 8 :1512–1513.
-
12
Mahoney FJ, Farley TA, Burbank DF, Leslie NH, McFarland LM, 1993. Evaluation of an intervention program for the control of an outbreak of shigellosis among institutionalized persons. J Infect Dis 168 :1177–1180.
-
13
Edwards BH, 1999. Salmonella and Shigella species. Clin Lab Med 19 :469–487.
-
14
DuPont HL, Levine MM, Hornick RB, Formal SB, 1989. Inoculum size in shigellosis and implications for expected mode of transmission. J Infect Dis 159 :1126–1128.
-
15
Replogle ML, Fleming DW, Cieslak PR, 2000. Emergence of antimicrobial-resistant shigellosis in Oregon. Clin Infect Dis 30 :515–519.
-
16
Cheasty T, Skinner JA, Rowe B, Threlfall EJ, 1998. Increasing incidence of antibiotic resistance in shigellas from humans in England and Wales: recommendations for therapy. Microb Drug Resist 4 :57–60.
-
17
Hoge CW, Gambel JM, Srijan A, Pitarangsi C, Echeverria P, 1998. Trends in antibiotic resistance among diarrheal pathogens isolated in Thailand over 15 years. Clin Infect Dis 26 :341–345.
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18
Sack RB, Rahman M, Yunus M, Khan EH, 1997. Antimicrobial resistance in organisms causing diarrheal disease. Clin Infect Dis 24 (Suppl 1):S102–S105.
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19
WHO, 1997. Vaccine research and development. New strategies for accelerating Shigella vaccine development. Wkly Epidemiol Rec 72 :73–79.
-
20
Zaki AM, DuPont HL, el Alamy MA, Arafat RR, Amin K, Awad MM, Bassiouni L, Imam IZ, el Malih GS, el Marsafie A, Mohieldin MS, Naguib T, Rakha MA, Sidaros M, Wasef N, Wright CE, Wyatt RG, 1986. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg 35 :1013–1022.
-
21
Naficy AB, Abu-Elyazeed R, Holmes JL, Rao MR, Savarino SJ, Kim Y, Wierzba TF, Peruski L, Lee YJ, Gentsch JR, Glass RI, Clemens JD, 1999. Epidemiology of rotavirus diarrhea in Egyptian children and implications for disease control. Am J Epidemiol 150 :770–777.
-
22
Naficy AB, Frenck RW, Abu-Elyazeed R, Kim Y, Rao MR, Savarino SJ, Wierzba TF, Hall E, Clemens JD, 2000. Seroepidemiology of Helicobacter pylori infection in a population of Egyptian children. Int J Epidemiol 29 :928–932.
-
23
Abu-Elyazeed R, Wierzba TF, Mourad AS, Peruski LF, Kay BA, Rao M, Churilla AM, Bourgeois AL, Mortagy AK, Kamal SM, Savarino SJ, Campbell JR, Murphy JR, Naficy A, Clemens JD, 1999. Epidemiology of enterotoxigenic Escherichia coli diarrhea in a pediatric cohort in a periurban area of lower Egypt. J Infect Dis 179 :382–389.
-
24
Farmer JJ III, 1999. Enterobacteriaceae: Introduction and Identification. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 442–458.
-
25
Bopp CA, Brenner FW, Wells JG, Strockbine N, 1999. Escherichia, Shigella, and Salmonella. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 459–474.
-
26
Tilson DL, 1999. Vibrio. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 497–506.
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27
Nachamkin I, 1999. Campylobacter and Arcobacter. Murray P, ed. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 716–726.
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28
Lefebvre J, Gosselin F, Ismail J, Lorange M, Lior H, Woodward D, 1995. Evaluation of commercial antisera for Shigella sero-grouping. J Clin Microbiol 33 :1997–2001.
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29
Nathoo KJ, Porteous JE, Siziya S, Wellington M, Mason E, 1998. Predictors of mortality in children hospitalized with dysentery in Harare, Zimbabwe. Cent Afr J Med 44 :272–276.
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30
Saidi SM, Iijima Y, Sang WK, Mwangudza AK, Oundo JO, Taga K, Aihara M, Nagayama K, Yamamoto H, Waiyaki PG, Honda T, 1997. Epidemiological study on infectious diarrheal diseases in children in a coastal rural area of Kenya. Microbiol Immunol 41 :773–778.
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31
Green MS, Block C, Cohen D, Slater PE, 1991. Four decades of shigellosis in Israel: epidemiology of a growing public health problem. Rev Infect Dis 13 :248–253.
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Khalil K, Khan SR, Mazhar K, Kaijser B, Lindblom GB, 1998. Occurrence and susceptibility to antibiotics of Shigella species in stools of hospitalized children with bloody diarrhea in Pakistan. Am J Trop Med Hyg 58 :800–803.
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Prado V, Lagos R, Nataro JP, San Martin O, Arellano C, Wang JY, Borczyk AA, Levine MM, 1999. Population-based study of the incidence of Shigella diarrhea and causative serotypes in Santiago, Chile. Pediatr Infect Dis J 18 :500–505.
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EPIDEMIOLOGY OF SHIGELLA-ASSOCIATED DIARRHEA IN RURAL EGYPTIAN CHILDREN
REMON R. ABU-ELYAZEED
REMON R. ABU-ELYAZEED
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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THOMAS F. WIERZBA
THOMAS F. WIERZBA
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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ROBERT W. FRENCK
ROBERT W. FRENCK
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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SHANNON D. PUTNAM
SHANNON D. PUTNAM
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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MALLA R. RAO
MALLA R. RAO
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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STEPHEN J. SAVARINO
STEPHEN J. SAVARINO
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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KARIM A. KAMAL
KARIM A. KAMAL
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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LEONARD F. PERUSKI JR.
LEONARD F. PERUSKI JR.
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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IBRAHIM A. ABD-EL MESSIH
IBRAHIM A. ABD-EL MESSIH
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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SAHAR A. EL-ALKAMY
SAHAR A. EL-ALKAMY
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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ABDOLLAH B. NAFICY
ABDOLLAH B. NAFICY
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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JOHN D. CLEMENS
JOHN D. CLEMENS
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt; U.S. Naval Research Unit No. 2, Jakarta, Indonesia; National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Abu Homos Field Research and Training Center, Egyptian Ministry of Health and Population, Beheira, Egypt; International Vaccine Institute, Seoul, Korea
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During the period from February 1995 to February 1998, the epidemiology of Shigella diarrhea was studied among children less than three years of age residing in Egypt’s Nile Delta. Children were visited twice a week and a stool sample was collected from any of them with diarrhea. The incidence of Shigella-associated diarrhea was 0.2 episodes/child-year, with S. flexneri being the most common serogroup isolated (55% of Shigella episodes). Younger age and the warm months increased the risk of developing Shigella-associated diarrhea, while breastfeeding was protective. Children with Shigella were ill for a mean of four days and passed a mean of six stools per day. Common symptoms included fever (35%), vomiting (19%), and dehydration (16%). Dysentery, however, was unusual, occurring in only 11% of the cases. In conclusion, Shigella-associated diarrhea remains relatively common in Egyptian children and supports the need for additional control measures including vaccine development.
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-
1
Guerrant RL, Hughes JM, Lima NL, Crane J, 1990. Diarrhea in developed and developing countries: magnitude, special settings, and etiologies. Rev Infect Dis 12 (Suppl 1):S41–S50.
-
2
Juckett G, 1999. Prevention and treatment of traveler’s diarrhea. Am Fam Physician 60 :119–124, 135–136.
-
3
Shlim DR, Hoge CW, Rajah R, Scott RM, Pandy P, Echeverria P, 1999. Persistent high risk of diarrhea among foreigners in Nepal during the first 2 years of residence. Clin Infect Dis 29 :613–616.
-
4
Kotloff KL, Winickoff JP, Ivanoff B, Clemens JD, Swerdlow DL, Sansonetti PJ, Adak GK, Levine MM, 1999. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ 77 :651–666.
-
5
Mohle-Boetani JC, Stapleton M, Finger R, Bean NH, Poundstone J, Blake PA, Griffin PM, 1995. Communitywide shigellosis: control of an outbreak and risk factors in child day-care centers. Am J Public Health 85 :812–816.
-
6
Hoffman RE, Shillam PJ, 1990. The use of hygiene, cohorting, and antimicrobial therapy to control an outbreak of shigellosis. Am J Dis Child 144 :219–221.
-
7
Pickering LK, Evans DG, DuPont HL, Vollet JJ 3rd, Evans DJ Jr, 1981. Diarrhea caused by Shigella, rotavirus, and Giardia in day-care centers: prospective study. J Pediatr 99 :51–56.
-
8
Baer JT, Vugia DJ, Reingold AL, Aragon T, Angulo FJ, Bradford WZ, 1999. HIV infection as a risk factor for shigellosis. Emerg Infect Dis 5 :820–823.
-
9
Germani Y, Minssart P, Vohito M, Yassibanda S, Glaziou P, Hocquet D, Berthelemy P, Morvan J, 1998. Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. Am J Trop Med Hyg 59 :1008–1014.
-
10
Angulo FJ, Swerdlow DL, 1995. Bacterial enteric infections in persons infected with human immunodeficiency virus. Clin Infect Dis 21 (Suppl 1):S84–S93.
-
11
van Oosterhout JJ, van der Hoek W, 1994. Infection with HIV, a risk factor for epidemic dysentery? A case-control study from Zambia. AIDS 8 :1512–1513.
-
12
Mahoney FJ, Farley TA, Burbank DF, Leslie NH, McFarland LM, 1993. Evaluation of an intervention program for the control of an outbreak of shigellosis among institutionalized persons. J Infect Dis 168 :1177–1180.
-
13
Edwards BH, 1999. Salmonella and Shigella species. Clin Lab Med 19 :469–487.
-
14
DuPont HL, Levine MM, Hornick RB, Formal SB, 1989. Inoculum size in shigellosis and implications for expected mode of transmission. J Infect Dis 159 :1126–1128.
-
15
Replogle ML, Fleming DW, Cieslak PR, 2000. Emergence of antimicrobial-resistant shigellosis in Oregon. Clin Infect Dis 30 :515–519.
-
16
Cheasty T, Skinner JA, Rowe B, Threlfall EJ, 1998. Increasing incidence of antibiotic resistance in shigellas from humans in England and Wales: recommendations for therapy. Microb Drug Resist 4 :57–60.
-
17
Hoge CW, Gambel JM, Srijan A, Pitarangsi C, Echeverria P, 1998. Trends in antibiotic resistance among diarrheal pathogens isolated in Thailand over 15 years. Clin Infect Dis 26 :341–345.
-
18
Sack RB, Rahman M, Yunus M, Khan EH, 1997. Antimicrobial resistance in organisms causing diarrheal disease. Clin Infect Dis 24 (Suppl 1):S102–S105.
-
19
WHO, 1997. Vaccine research and development. New strategies for accelerating Shigella vaccine development. Wkly Epidemiol Rec 72 :73–79.
-
20
Zaki AM, DuPont HL, el Alamy MA, Arafat RR, Amin K, Awad MM, Bassiouni L, Imam IZ, el Malih GS, el Marsafie A, Mohieldin MS, Naguib T, Rakha MA, Sidaros M, Wasef N, Wright CE, Wyatt RG, 1986. The detection of enteropathogens in acute diarrhea in a family cohort population in rural Egypt. Am J Trop Med Hyg 35 :1013–1022.
-
21
Naficy AB, Abu-Elyazeed R, Holmes JL, Rao MR, Savarino SJ, Kim Y, Wierzba TF, Peruski L, Lee YJ, Gentsch JR, Glass RI, Clemens JD, 1999. Epidemiology of rotavirus diarrhea in Egyptian children and implications for disease control. Am J Epidemiol 150 :770–777.
-
22
Naficy AB, Frenck RW, Abu-Elyazeed R, Kim Y, Rao MR, Savarino SJ, Wierzba TF, Hall E, Clemens JD, 2000. Seroepidemiology of Helicobacter pylori infection in a population of Egyptian children. Int J Epidemiol 29 :928–932.
-
23
Abu-Elyazeed R, Wierzba TF, Mourad AS, Peruski LF, Kay BA, Rao M, Churilla AM, Bourgeois AL, Mortagy AK, Kamal SM, Savarino SJ, Campbell JR, Murphy JR, Naficy A, Clemens JD, 1999. Epidemiology of enterotoxigenic Escherichia coli diarrhea in a pediatric cohort in a periurban area of lower Egypt. J Infect Dis 179 :382–389.
-
24
Farmer JJ III, 1999. Enterobacteriaceae: Introduction and Identification. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 442–458.
-
25
Bopp CA, Brenner FW, Wells JG, Strockbine N, 1999. Escherichia, Shigella, and Salmonella. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 459–474.
-
26
Tilson DL, 1999. Vibrio. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 497–506.
-
27
Nachamkin I, 1999. Campylobacter and Arcobacter. Murray P, ed. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 716–726.
-
28
Lefebvre J, Gosselin F, Ismail J, Lorange M, Lior H, Woodward D, 1995. Evaluation of commercial antisera for Shigella sero-grouping. J Clin Microbiol 33 :1997–2001.
-
29
Nathoo KJ, Porteous JE, Siziya S, Wellington M, Mason E, 1998. Predictors of mortality in children hospitalized with dysentery in Harare, Zimbabwe. Cent Afr J Med 44 :272–276.
-
30
Saidi SM, Iijima Y, Sang WK, Mwangudza AK, Oundo JO, Taga K, Aihara M, Nagayama K, Yamamoto H, Waiyaki PG, Honda T, 1997. Epidemiological study on infectious diarrheal diseases in children in a coastal rural area of Kenya. Microbiol Immunol 41 :773–778.
-
31
Green MS, Block C, Cohen D, Slater PE, 1991. Four decades of shigellosis in Israel: epidemiology of a growing public health problem. Rev Infect Dis 13 :248–253.
-
32
Rawashdeh MO, Ababneh AM, Shurman AA, 1994. Shigellosis in Jordanian children: a clinico-epidemiologic prospective study and susceptibility to antibiotics. J Trop Pediatr 40 :355–359.
-
33
Albert MJ, Faruque AS, Faruque SM, Sack RB, Mahalanabis D, 1999. Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh. J Clin Microbiol 37 :3458–3464.
-
34
Khalil K, Khan SR, Mazhar K, Kaijser B, Lindblom GB, 1998. Occurrence and susceptibility to antibiotics of Shigella species in stools of hospitalized children with bloody diarrhea in Pakistan. Am J Trop Med Hyg 58 :800–803.
-
35
Ghosh AR, Sehgal SC, 1998. Shigella infections among children in Andaman–an archipelago of tropical islands in Bay of Bengal. Epidemiol Infect 121 :43–48.
-
36
Yurdakok K, Sahin N, Ozmert E, Berkman E, 1997. Shigella gastroenteritis: clinical and epidemiological aspects, and antibiotic susceptibility. Acta Paediatr Jpn 39 :681–684.
-
37
Lopez EL, Prado-Jimenez V, O’Ryan-Gallardo M, Contrini MM, 2000. Shigella and Shiga toxin-producing Escherichia coli causing bloody diarrhea in Latin America. Infect Dis Clin North Am 14 :41–65.
-
38
Prado V, Lagos R, Nataro JP, San Martin O, Arellano C, Wang JY, Borczyk AA, Levine MM, 1999. Population-based study of the incidence of Shigella diarrhea and causative serotypes in Santiago, Chile. Pediatr Infect Dis J 18 :500–505.
-
39
Townes JM, Quick R, Gonzales OY, Linares M, Damiani E, Bopp CA, Wahlquist SP, Hutwagner LC, Hanover E, Mintz ED, Tauxe RV, 1997. Etiology of bloody diarrhea in Bolivian children: implications for empiric therapy. Bolivian Dysentery Study Group. J Infect Dis 175 :1527–1530.
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40
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