Trend and disease burden of bacillary dysentery in China (1991-2000)/Evolution de la dysenterie bacillaire et charge de morbidite due a cette maladie en Chine (1991-2000)/Disenteria bacilar: tendencias y carga de morbilidad en China (1991-2000)

• Published in: Bulletin of the World Health Organization 2006-07, Vol.84 (7), p.561
• Main Authors: Xu, Zhi-yi, Li, Zheng-mao, Wang, Xuan-yi, Ma, Jianming, Xu, Jun-hong, Lee, Hyejon, Zhou, Weizhong, Xiao, Donglou, Zhao, Yuliang, Su, Pu-yu, Shen, Bing, Ouyang, Pei-ying, von Seidlein, Lorenz, Li, Weiming, Wang, Zijun, Deen, Jacqueline, Chang, Nayoon, Song, Yang, Gong, Jian, Clemens, John D, Tao, Fangbiao
• Format: Article
• Language: English
• Subjects: Causes of; Health surveys; Risk factors; Shigellosis
• ISSN: 0042-9686

Objective We aimed to determine the burden of bacillary dysentery in China, its cross-regional variations, trends in morbidity and mortality, the causative bacterial species and antimicrobial resistance patterns. Methods We extracted and integrated governmental statistics and relevant medical literature published from 1991 to 2000. Data were also collected from one general hospital each for the six provinces and Jin-an district, Shanghai, representative of six geographical regions and a modern city. Findings In 2000, 0.8-1.7 million episodes of bacillary dysentery occurred of which 0.5 to 0.7 million were treated at health-care facilities and 0.15-0.20 million patients were hospitalized. The highest morbidity and mortality rates were among the youngest and oldest age groups. Bacillary dysentery peaked during the summer months. The major causative species was Shigella flexneri (86%) and the predominant S. flexneriserotype was 2a (80%). About 74-80% of Shigella isolates remained susceptible to fluorinated quinolones. Conclusion We conclude that while morbidity and mortality due to bacillary dysentery has decreased considerably in China in the past decade due to increasing access to affordable health care and antibiotics, a considerable burden exists among the youngest and oldest age groups and in regions with low economic development. We suggest that while a vaccine would be effective for short- and medium-term control of bacillary dysentery, improved water supply, sanitation, and hygiene are likely to be required for long-term control. Bulletin of the World Health Organization 2006;84:561-568. Resume Evolution de la dysenterie bacillaire et charge de morbidite due a cette maladie en Chine (1991-2000) Objectif L'etude visait a determiner la charge de dysenterie bacillaire en Chine, les variations interregionales, les tendances de la morbidite et de la mortalite, les agents etiologiques bacteriens et les schemas de resistance aux antimicrobiens. Methodes Les statistiques publiques et les documents medicaux pertinents publies de 1991 a 2000 ont ete extraits et pris en compte dans l'etude. On a egalement recueilli des donnees aupres d'un hopital general de chacune des six provinces considerees et du district de Jin an a Shanghai, ces hopitaux etant representatifs de six regions geographiques et d'une ville moderne. Resultats En 2000, 0,8 a 1,7 million d'episodes de dysenterie bacillaire on ete enregistres, dont 0,5 a 0,7 million ont ete traites dans des etablis