Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.

<h4>Background</h4>Shigella, the causative agent of shigellosis, is a major global public health concern, particularly in developing countries with poor sanitation. A comprehensive and current understanding of the prevalent species and serotypes of shigellosis is essential for both disea...

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Main Authors: Zhili Chang, Shuting Lu, Lihong Chen, Qi Jin, Jian Yang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0052515&type=printable
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author Zhili Chang
Shuting Lu
Lihong Chen
Qi Jin
Jian Yang
author_facet Zhili Chang
Shuting Lu
Lihong Chen
Qi Jin
Jian Yang
author_sort Zhili Chang
collection DOAJ
description <h4>Background</h4>Shigella, the causative agent of shigellosis, is a major global public health concern, particularly in developing countries with poor sanitation. A comprehensive and current understanding of the prevalent species and serotypes of shigellosis is essential for both disease prevention and vaccine development. However, no current data are available on the causative species/serotypes of shigellosis in mainland China during the past decade.<h4>Methods and findings</h4>Relevant studies addressing the prevalent species of shigellosis in mainland China from January 2001 to December 2010 were identified from PubMed and the Chinese BioMedical Literature Database (in Chinese) until April 2012. A total of 131 eligible articles (136 studies) were included in this review. Meta-analyses showed that the prevalences of S. flexneri and S. sonnei were 76.2% (95% CI, 73.7%-78.5%) and 21.3% (95% CI, 19.0%-23.7%), respectively. Stratified analyses indicated a decrease in the prevalence of S. flexneri cases and an increase in the prevalence of S. sonnei cases concurrent with the rapid economic growth experienced by China in recent years. Moreover, significantly higher rates of S. sonnei were observed in the East, North and Northeast regions of China, as compared to the rest of the country. These phenomena imply the possible association between the prevalent species of Shigella and regional economic status; however, additional factors also exist and require further investigations. Moreover, the two major serotypes S. flexneri 2a and 4c accounted for 21.5% (95% CI, 16.7%-27.4%) and 12.9% (95% CI 9.8%-16.9%) of S. flexneri infections, respectively, in the past decade. However, these results were found to be frequently heterogeneous (p for Q tests <0.01).<h4>Conclusions</h4>This study provides an updated review of the causative agents of shigellosis in mainland China and focuses on the importance of strengthening prevention and research efforts on S. sonnei and the newly emerged S. flexneri serotype 4c.
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spelling doaj-art-5cef448903604fa990fc009e2127c9552025-08-20T02:35:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5251510.1371/journal.pone.0052515Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.Zhili ChangShuting LuLihong ChenQi JinJian Yang<h4>Background</h4>Shigella, the causative agent of shigellosis, is a major global public health concern, particularly in developing countries with poor sanitation. A comprehensive and current understanding of the prevalent species and serotypes of shigellosis is essential for both disease prevention and vaccine development. However, no current data are available on the causative species/serotypes of shigellosis in mainland China during the past decade.<h4>Methods and findings</h4>Relevant studies addressing the prevalent species of shigellosis in mainland China from January 2001 to December 2010 were identified from PubMed and the Chinese BioMedical Literature Database (in Chinese) until April 2012. A total of 131 eligible articles (136 studies) were included in this review. Meta-analyses showed that the prevalences of S. flexneri and S. sonnei were 76.2% (95% CI, 73.7%-78.5%) and 21.3% (95% CI, 19.0%-23.7%), respectively. Stratified analyses indicated a decrease in the prevalence of S. flexneri cases and an increase in the prevalence of S. sonnei cases concurrent with the rapid economic growth experienced by China in recent years. Moreover, significantly higher rates of S. sonnei were observed in the East, North and Northeast regions of China, as compared to the rest of the country. These phenomena imply the possible association between the prevalent species of Shigella and regional economic status; however, additional factors also exist and require further investigations. Moreover, the two major serotypes S. flexneri 2a and 4c accounted for 21.5% (95% CI, 16.7%-27.4%) and 12.9% (95% CI 9.8%-16.9%) of S. flexneri infections, respectively, in the past decade. However, these results were found to be frequently heterogeneous (p for Q tests <0.01).<h4>Conclusions</h4>This study provides an updated review of the causative agents of shigellosis in mainland China and focuses on the importance of strengthening prevention and research efforts on S. sonnei and the newly emerged S. flexneri serotype 4c.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0052515&type=printable
spellingShingle Zhili Chang
Shuting Lu
Lihong Chen
Qi Jin
Jian Yang
Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
PLoS ONE
title Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
title_full Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
title_fullStr Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
title_full_unstemmed Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
title_short Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis.
title_sort causative species and serotypes of shigellosis in mainland china systematic review and meta analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0052515&type=printable
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AT lihongchen causativespeciesandserotypesofshigellosisinmainlandchinasystematicreviewandmetaanalysis
AT qijin causativespeciesandserotypesofshigellosisinmainlandchinasystematicreviewandmetaanalysis
AT jianyang causativespeciesandserotypesofshigellosisinmainlandchinasystematicreviewandmetaanalysis