Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000.

Hdl Handle:
http://hdl.handle.net/10144/17254
Title:
Case management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000.
Authors:
Guerin, P J; Brasher, C; Baron, E; Mic, D; Grimont, F; Ryan, M; Aavitsland, P; Legros, D
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
From December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region. Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5-1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1-4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.
Affiliation:
Epicentre, 8 rue Saint Sabin, 75011 Paris, France. philippe.guerin@epicentre.msf.org
Publisher:
Elsevier
Issue Date:
Nov-2004
URI:
http://hdl.handle.net/10144/17254
DOI:
10.1016/j.trstmh.2004.01.005
PubMed ID:
15363643
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorGuerin, P J-
dc.contributor.authorBrasher, C-
dc.contributor.authorBaron, E-
dc.contributor.authorMic, D-
dc.contributor.authorGrimont, F-
dc.contributor.authorRyan, M-
dc.contributor.authorAavitsland, P-
dc.contributor.authorLegros, D-
dc.date.accessioned2008-01-31T14:52:53Z-
dc.date.available2008-01-31T14:52:53Z-
dc.date.issued2004-11-
dc.identifier.citationCase management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000. 2004, 98 (11):635-43 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid15363643-
dc.identifier.doi10.1016/j.trstmh.2004.01.005-
dc.identifier.urihttp://hdl.handle.net/10144/17254-
dc.description.abstractFrom December 1999 to the end of February 2000, 4218 cases of dysentery were reported in Kenema district, southeastern Sierra Leone, by a Médecins Sans Frontières team operating in this region. Shigella dysenteriae serotype 1 was isolated from the early cases. The overall attack rate was 7.5% but higher among children under 5 years (11.2%) compared to the rest of the population (6.8%) (RR = 1.6; 95% CI 1.5-1.8). The case fatality ratio was 3.1%, and higher for children under 5 years (6.1% vs. 2.1%) (RR = 2.9; 95% CI 2.1-4.1). A case management strategy based on stratification of affected cases was chosen in this resource-poor setting. Patients considered at higher risk of death were treated with a 5 day ciprofloxacin regimen in isolation centres. Five hundred and eighty-three cases were treated with a case fatality ratio of 0.9%. Patients who did not have signs of severity when seen by health workers were given hygiene advice and oral rehydration salts. This strategy was effective in this complex emergency.en
dc.language.isoenen
dc.publisherElsevier-
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAge Distributionen
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshAnimalsen
dc.subject.meshAnti-Infective Agentsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshCiprofloxacinen
dc.subject.meshDisease Outbreaksen
dc.subject.meshDrug Resistanceen
dc.subject.meshDysentery, Bacillaryen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshSerotypingen
dc.subject.meshSex Distributionen
dc.subject.meshShigella dysenteriaeen
dc.subject.meshSierra Leoneen
dc.titleCase management of a multidrug-resistant Shigella dysenteriae serotype 1 outbreak in a crisis context in Sierra Leone, 1999-2000.en
dc.contributor.departmentEpicentre, 8 rue Saint Sabin, 75011 Paris, France. philippe.guerin@epicentre.msf.orgen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

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