{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:20:29Z","timestamp":1790144429358,"version":"4.0.1"},"reference-count":20,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Estimates of the prevalence of\n                    <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n                    spp. are limited by the suboptimal sensitivity of current diagnostic and surveillance methods. We used a quantitative PCR (qPCR) assay to detect\n                    <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n                    in the stool samples of 3,533 children aged &lt;59 months from the Gambia, Mali, Kenya, and Bangladesh, with or without moderate-to-severe diarrhea (MSD). We compared the results from conventional culture to those from qPCR for the\n                    <jats:italic>Shigella ipaH<\/jats:italic>\n                    gene. Using MSD as the reference standard, we determined the optimal cutpoint to be 2.9 \u00d7 10\n                    <jats:sup>4<\/jats:sup>\n                    <jats:italic>ipaH<\/jats:italic>\n                    copies per 100 ng of stool DNA for set 1 (\n                    <jats:italic>n<\/jats:italic>\n                    = 877). One hundred fifty-eight (18%) specimens yielded &gt;2.9 \u00d7 10\n                    <jats:sup>4<\/jats:sup>\n                    <jats:italic>ipaH<\/jats:italic>\n                    copies. Ninety (10%) specimens were positive by traditional culture for\n                    <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n                    . Individuals with \u22652.9 \u00d7 10\n                    <jats:sup>4<\/jats:sup>\n                    <jats:italic>ipaH<\/jats:italic>\n                    copies have 5.6-times-higher odds of having diarrhea than those with &lt;2.9 \u00d7 10\n                    <jats:sup>4<\/jats:sup>\n                    <jats:italic>ipaH<\/jats:italic>\n                    copies (95% confidence interval, 3.7 to 8.5;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.0001). Nearly identical results were found using an independent set of samples. qPCR detected 155 additional MSD cases with high copy numbers of\n                    <jats:italic>ipaH<\/jats:italic>\n                    , a 90% increase from the 172 cases detected by culture in both samples. Among a subset (\n                    <jats:italic>n<\/jats:italic>\n                    = 2,874) comprising MSD cases and their age-, gender-, and location-matched controls, the fraction of MSD cases that were attributable to\n                    <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n                    infection increased from 9.6% (\n                    <jats:italic>n<\/jats:italic>\n                    = 129) for culture to 17.6% (\n                    <jats:italic>n<\/jats:italic>\n                    = 262) for qPCR when employing our cutpoint. We suggest that qPCR with a cutpoint of approximately 1.4 \u00d7 10\n                    <jats:sup>4<\/jats:sup>\n                    <jats:italic>ipaH<\/jats:italic>\n                    copies be the new reference standard for the detection and diagnosis of shigellosis in children in low-income countries. The acceptance of this new standard would substantially increase the fraction of MSD cases that are attributable to\n                    <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n                    .\n                  <\/jats:p>","DOI":"10.1128\/jcm.02713-12","type":"journal-article","created":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T22:27:18Z","timestamp":1364423238000},"page":"1740-1746","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":109,"title":["Quantitative PCR for Detection of Shigella Improves Ascertainment of Shigella Burden in Children with Moderate-to-Severe Diarrhea in Low-Income Countries"],"prefix":"10.1128","volume":"51","author":[{"given":"Brianna","family":"Lindsay","sequence":"first","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Ochieng","sequence":"additional","affiliation":[{"name":"CDC\/Kenya Medical Research Institute (KEMRI) Research Station, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman N.","family":"Ikumapayi","sequence":"additional","affiliation":[{"name":"Medical Research Council, Basse, the Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliou","family":"Toure","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins au Mali, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilruba","family":"Ahmed","sequence":"additional","affiliation":[{"name":"icddr,b, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Li","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Panchalingam","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myron M.","family":"Levine","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Kotloff","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Rasko","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn R.","family":"Morris","sequence":"additional","affiliation":[{"name":"University of Maryland, School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Juma","sequence":"additional","affiliation":[{"name":"CDC\/Kenya Medical Research Institute (KEMRI) Research Station, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry S.","family":"Fields","sequence":"additional","affiliation":[{"name":"CDC\/Kenya Medical Research Institute (KEMRI) Research Station, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Dione","sequence":"additional","affiliation":[{"name":"Medical Research Council, Basse, the Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dramane","family":"Malle","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins au Mali, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Becker","sequence":"additional","affiliation":[{"name":"University of Virginia, School of Medicine, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R.","family":"Houpt","sequence":"additional","affiliation":[{"name":"University of Virginia, School of Medicine, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Nataro","sequence":"additional","affiliation":[{"name":"University of Virginia, School of Medicine, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halvor","family":"Sommerfelt","sequence":"additional","affiliation":[{"name":"University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Pop","sequence":"additional","affiliation":[{"name":"University of Maryland, College Park, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Oundo","sequence":"additional","affiliation":[{"name":"CDC\/Kenya Medical Research Institute (KEMRI) Research Station, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Antonio","sequence":"additional","affiliation":[{"name":"Medical Research Council, Basse, the Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anowar","family":"Hossain","sequence":"additional","affiliation":[{"name":"icddr,b, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boubou","family":"Tamboura","sequence":"additional","affiliation":[{"name":"Centre pour le D\u00e9veloppement des Vaccins au Mali, Bamako, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. 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