Highlights • Systematic review of longitudinal Shigella outcomes in children. • Shigella is associated with continued diarrhea and linear growth faltering. • There is a need for standardized measurement and reporting of Shigella outcomes. Objectives We conducted a systematic review of the longitudinal consequences of Shigella infection in children to inform the value proposition for an effective vaccine. Methods We searched PubMed and Embase for studies published from January 01, 1980 to December 12, 2022 and conducted in low- and middle-income countries that included longitudinal follow-up after Shigella detection among children aged <5 years, irrespective of language. We collected data on all outcomes subsequent to Shigella detection, except mortality. Results Of 2627 papers identified, 52 met inclusion criteria. The median sample size of children aged <5 years was 66 (range 5-2172). Data were collected in 20 countries; 56% (n = 29) of the publications included Bangladesh. The most common outcomes related to diarrhea (n = 20), linear growth (n = 14), and the mean total cost of a Shigella episode (n = 4; range: $ 6.22-31.10). Among children with Shigella diarrhea, 2.9-61.1% developed persistent diarrhea (≥14 days); the persistence was significantly more likely among children who were malnourished, had bloody stool, or had multidrug-resistant Shigella . Cumulative Shigella infections over the first 2 years of life contributed to the greatest loss in length-for-age z-score. Conclusion We identified evidence that Shigella is associated with persistent diarrhea, linear growth faltering, and economic impact to the family.
【저자키워드】 Vaccine, diarrhea, Shigella, stunting, enteric, Growth faltering,