Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan
Shigella flexneri is considered as an important causative agent of Shigellosis causing diarrhea in the countries with a low socioeconomic status. No study has been carried out on the molecular prevalence of S. flexneri in Khyber Pakhtunkhwa, Pakistan. So this study was designed to evaluate the molecular prevalence of S. flexneri and their associated risk factors. A total of 2014 diarrheal stool samples were collected from January 2016 to May 2017 from pediatrics patients of Khyber Pakhtunkhwa followed by identification of S. flexneri through biochemical, serological, and molecular methods. The overall prevalence of Shigella species was found to be 7.9% (n = 160). The predominant Shigella specie was S. flexneri (n = 155, 96.8%) followed by S. boydii (n = 5, 3.1%). Interestingly, no sample was found positive for S. sonnei and S. dysenteriae. The majority of Shigellosis cases occurred from June to September. Potential risk factors related with Shigellosis were unhygienic latrine usage, bad hand washing, and consumption of unhygienic food and water, and pipe leakage in the sewage system. In this study, we have observed a high number of Shigellosis cases especially those caused by S. flexneri. It is suggested that effective health awareness programs should be organized by the regional health authorities to minimize the magnitude of pediatrics Shigellosis.
KeywordsS. flexneri Pediatrics Molecular epidemiology Diarrhea Endemic area Pakistan
Muhammad Qasim, Iqbal Nisa, Arnold Driessen, Jeroen Nijland, and Fazli Bari designed the study, carried out the experiments, analyzed the data, and drafted the manuscript. Muhammad Qasim, Iqbal Nisa, and Jeroen Nijland helped in data analysis and results interpretation. Muhammad Qasim, Arnold Driessen, Jeroen Nijland, Fazli Bari, Mohammad Haroon, Hazir Rehman, Nusrat Yasin, Taj Ali Khan, Mubbashir Hussain, and Waheed Ullah critically reviewed and commented on the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. In addition, the institutional research ethical committee approved the present study.
Informed consent was obtained from all patients/guardian for being included in the study.
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