A look back at an ongoing problem: Shigella dysenteriae type 1 epidemics in refugee settings in Central Africa (1993-1995).
AffiliationEpicentre, Paris, France.
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AbstractBACKGROUND: Shigella dysenteriae type 1 (Sd1) is a cause of major dysentery outbreaks, particularly among children and displaced populations in tropical countries. Although outbreaks continue, the characteristics of such outbreaks have rarely been documented. Here, we describe the Sd1 outbreaks occurring between 1993 and 1995 in 11 refugee settlements in Rwanda, Tanzania and Democratic Republic of the Congo (DRC). We also explored the links between the different types of the camps and the magnitude of the outbreaks. METHODOLOGY/PRINCIPAL FINDINGS: Number of cases of bloody diarrhea and deaths were collected on a weekly basis in 11 refugee camps, and analyzed retrospectively. Between November 1993 and February 1995, 181,921 cases of bloody diarrhea were reported. Attack rates ranged from 6.3% to 39.1% and case fatality ratios (CFRs) from 1.5% to 9.0% (available for 5 camps). The CFRs were higher in children under age 5. In Tanzania where the response was rapidly deployed, the mean attack rate was lower than in camps in the region of Goma without an immediate response (13.3% versus 32.1% respectively). CONCLUSIONS/SIGNIFICANCE: This description, and the areas where data is missing, highlight both the importance of collecting data in future epidemics, difficulties in documenting outbreaks occurring in complex emergencies and most importantly, the need to assure that minimal requirements are met.
- [An outbreak of Shigella dysenteriae type 1 dysentery in a refugee camp in Rwanda].
- Authors: Paquet C, Leborgne P, Sasse A, Varaine F
- Issue date: 1995 May-Jun
- [Physicians without borders and diarrhea as a cause of illness and death in refugee camps].
- Authors: Meijman HJ, Blok ML, Griekspoor A
- Issue date: 1996 Aug 10
- [Ciprofloxacin in the treatment of dysentery caused by type 1 Shigella dysenteriae during an epidemic in Rwandan refugees in Goma in 1994].
- Authors: Laureillard D, Paquet C, Malvy D
- Issue date: 1998 Jul-Aug
- Mortality due to shigellosis: community and hospital data.
- Authors: Bennish ML, Wojtyniak BJ
- Issue date: 1991 Mar-Apr
- Shigella dysenteriae type 1 in Zimbabwe.
- Authors: Nathoo KJ
- Issue date: 1997 Mar