{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T15:54:32Z","timestamp":1775922872466,"version":"3.50.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,6,14]],"date-time":"2020-06-14T00:00:00Z","timestamp":1592092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sex differences in the incidence of infectious diseases can provide insight to the biological mechanism of infection, disease susceptibility, severity and vaccine development. The consistency of age-specific sex differences in the incidence rates (IRs) of shigellosis is unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>National data on cases of shigellosis by sex, age group and calendar year were obtained from nine countries, for a period of 6\u201325\u2009years. The male to female incidence rate ratios (RR) were calculated by country, years and age group. For each age group, meta-analytic methods were used for computing pooled incidence RRs by country and years. Meta-regression was performed to estimate the contribution of age, country and time period to the differences in the male : female RRs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the age groups &amp;lt;1, 1\u20134, 5\u20139 and 10\u201314, there were excess IRs in males. The pooled incidence RRs (with 95% CI) were 1.21 (1.14\u20131.28), 1.17 (1.12\u20131.22), 1.04 (1.00\u20131.09) and 1.09 (1.01\u20131.18), respectively. In young adults, there was excess IR in females with RR\u2009=\u20090.80 (0.72\u20130.9). In middle aged and older adults, there was a slight excess in males with RR\u2009=\u20091.01 (0.89\u20131.15) and RR\u2009=\u20091.18 (1.09\u20131.28), respectively. In the meta-regression, age was the only variable that significantly contributed to the variation in the RRs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The higher IRs in male infants and young children does not appear to be related to behavioral factors and genetic and hormonal factors could be important. In the older age groups, the higher rates in adult females may be due to behavioral factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckaa087","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T11:09:56Z","timestamp":1587380996000},"page":"974-981","source":"Crossref","is-referenced-by-count":8,"title":["Sex differences in shigellosis incidence rates: analysis of national data from nine countries using meta-analytic method"],"prefix":"10.1093","volume":"30","author":[{"given":"Victoria","family":"Peer","sequence":"first","affiliation":[{"name":"School of Public Health, University of Haifa, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naama","family":"Schwartz","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Haifa, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manfred S","family":"Green","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Haifa, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,6,14]]},"reference":[{"key":"2020100603543175800_ckaa087-B1","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/QCO.0000000000000475","article-title":"Recent insights into Shigella","volume":"31","author":"Baker","year":"2018","journal-title":"Curr Opin Infect Dis"},{"key":"2020100603543175800_ckaa087-B2","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4161\/gmic.19325","article-title":"Shigella: a model of virulence regulation in vivo","volume":"3","author":"Marteyn","year":"2012","journal-title":"Gut Microbes"},{"key":"2020100603543175800_ckaa087-B3","doi-asserted-by":"crossref","first-page":"e353","DOI":"10.1371\/journal.pmed.0030353","article-title":"A multicenter study of Shigella diarrhoea in six Asian countries: disease burden, clinical manifestations, and microbiology","volume":"3","author":"von Seidlein","year":"2006","journal-title":"PLoS Med"},{"key":"2020100603543175800_ckaa087-B4","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1186\/s12879-016-1977-1","article-title":"The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004\u20132014","volume":"16","author":"Chang","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2020100603543175800_ckaa087-B5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s41043-016-0073-x","article-title":"Shigellosis in Nepal: 13 years review of nationwide surveillance","volume":"35","author":"Shakya","year":"2016","journal-title":"J Health Popul Nutr"},{"key":"2020100603543175800_ckaa087-B6","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1017\/S0950268817002771","article-title":"Sex- and age patterns in incidence of infectious diseases in Germany: analyses of surveillance records over a 13-year period (2001\u20132013","volume":"146","author":"Walter","year":"2018","journal-title":"Epidemiol Infect"},{"key":"2020100603543175800_ckaa087-B7","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s12889-018-5115-4","article-title":"Disparities in severe Shigellosis among adults-foodborne diseases active surveillance network, 2002\u20132014","volume":"18","author":"McCrickard","year":"2018","journal-title":"BMC Public Health"},{"key":"2020100603543175800_ckaa087-B8","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1017\/S0950268814000260","article-title":"Recent trends in the epidemiology of Shigellosis in Israel","volume":"142","author":"Cohen","year":"2014","journal-title":"Epidemiol Infect"},{"key":"2020100603543175800_ckaa087-B9","year":"2018"},{"key":"2020100603543175800_ckaa087-B10","year":"2018"},{"key":"2020100603543175800_ckaa087-B11","year":"2018"},{"key":"2020100603543175800_ckaa087-B12","year":"2020"},{"key":"2020100603543175800_ckaa087-B13","year":"2018"},{"key":"2020100603543175800_ckaa087-B14","year":"2018"},{"key":"2020100603543175800_ckaa087-B15","year":"2020"},{"key":"2020100603543175800_ckaa087-B16","year":"2018"},{"key":"2020100603543175800_ckaa087-B17"},{"key":"2020100603543175800_ckaa087-B18","year":"2018"},{"key":"2020100603543175800_ckaa087-B19","year":"2020"},{"key":"2020100603543175800_ckaa087-B20","year":"2020"},{"key":"2020100603543175800_ckaa087-B21","year":"2018"},{"key":"2020100603543175800_ckaa087-B22","year":"2018"},{"key":"2020100603543175800_ckaa087-B23","year":"2018"},{"key":"2020100603543175800_ckaa087-B24","year":"2020"},{"key":"2020100603543175800_ckaa087-B25","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Statist Med"},{"key":"2020100603543175800_ckaa087-B26","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1093\/ije\/21.2.381","article-title":"The male predominance in the incidence of infectious diseases in children: a postulated explanation for disparities in the literature","volume":"21","author":"Green","year":"1992","journal-title":"Int J Epidemiol"},{"key":"2020100603543175800_ckaa087-B27","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1017\/S0950268807009934","article-title":"Sexual dimorphism in campylobacteriosis","volume":"136","author":"Strachan","year":"2008","journal-title":"Epidemiol Infect"},{"key":"2020100603543175800_ckaa087-B28","doi-asserted-by":"crossref","first-page":"e62390","DOI":"10.1371\/journal.pone.0062390","article-title":"Sex bias in infectious disease epidemiology: patterns and processes","volume":"8","author":"Guerra-Silveira","year":"2013","journal-title":"PLoS One"},{"key":"2020100603543175800_ckaa087-B29","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1079\/PHN2001156","article-title":"Eating patterns\u2014temporal distribution, converging and diverging foods, meals eaten inside and outside of the home\u2014implications for developing FBDG","volume":"4","author":"Kearney","year":"2001","journal-title":"Public Health Nutr"},{"key":"2020100603543175800_ckaa087-B30","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1093\/trstmh\/tru167","article-title":"Sex-based differences in immune function and responses to vaccination","volume":"109","author":"Klein","year":"2015","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2020100603543175800_ckaa087-B31","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40246-018-0185-z","article-title":"The X chromosome and sex-specific effects in infectious disease susceptibility","volume":"13","author":"Schurz","year":"2019","journal-title":"Hum Genomics"},{"key":"2020100603543175800_ckaa087-B32","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s12016-017-8648-x","article-title":"Sexual dimorphism in innate immunity","volume":"56","author":"Jaillon","year":"2019","journal-title":"Clin Rev Allerg Immunol"},{"key":"2020100603543175800_ckaa087-B33","doi-asserted-by":"crossref","first-page":"77","DOI":"10.7150\/jgen.8123","article-title":"Chromosome imbalance as a driver of sex disparity in disease","volume":"2","author":"Abramowitz","year":"2014","journal-title":"J Genomics"},{"key":"2020100603543175800_ckaa087-B34","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1373\/clinchem.2013.204123","article-title":"Complex biological pattern of fertility hormones in children and adolescents: a study of healthy children from the CALIPER cohort and establishment of pediatric reference intervals","volume":"59","author":"Konforte","year":"2013","journal-title":"Clin Chem"},{"key":"2020100603543175800_ckaa087-B35","doi-asserted-by":"crossref","first-page":"4709","DOI":"10.1210\/jc.2013-1677","article-title":"Postnatal ovarian activation has effects in estrogen target tissues in infant girls","volume":"98","author":"Kuiri-H\u00e4nninen","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"2020100603543175800_ckaa087-B36","doi-asserted-by":"crossref","DOI":"10.1128\/IAI.00560-17","article-title":"Cooperative immune suppression by Escherichia coli and shigella effector proteins","volume":"86","author":"de Jong","year":"2018","journal-title":"Infect Immun"},{"key":"2020100603543175800_ckaa087-B37","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1080\/21645515.2019.1594132","article-title":"Shigella-mediated immunosuppression in the human gut: subversion extends from innate to adaptive immune responses","volume":"15","author":"Brunner","year":"2019","journal-title":"Hum Vaccin Immunother"},{"key":"2020100603543175800_ckaa087-B38","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3389\/fimmu.2015.00219","article-title":"Shigella manipulates host immune responses by delivering effector proteins with specific roles","volume":"6","author":"Ashida","year":"2015","journal-title":"Front Immunol"},{"key":"2020100603543175800_ckaa087-B39","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.coi.2011.06.001","article-title":"Shigella are versatile mucosal pathogens that circumvent the host innate immune system","volume":"23","author":"Ashida","year":"2011","journal-title":"Curr Opin Immunol"},{"key":"2020100603543175800_ckaa087-B40","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1182\/blood-2003-10-3380","article-title":"17beta-estradiol (E2) modulates cytokine and chemokine expression in human monocyte-derived dendritic cells","volume":"104","author":"Bengtsson","year":"2004","journal-title":"Blood"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/eurpub\/article-pdf\/30\/5\/974\/33837764\/ckaa087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurpub\/article-pdf\/30\/5\/974\/33837764\/ckaa087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T08:16:27Z","timestamp":1601972187000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/30\/5\/974\/5857278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,14]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,6,14]]},"published-print":{"date-parts":[[2020,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckaa087","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,10]]},"published":{"date-parts":[[2020,6,14]]}}}