{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:58:41Z","timestamp":1792821521256,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013393","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000}}],"reference-count":79,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gates Foundation","award":["INV-033228"],"award-info":[{"award-number":["INV-033228"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Introduction<\/jats:title>\n \n \n Shigella<\/jats:italic>\n <\/jats:italic>\n is a leading cause of diarrhea worldwide. While the burden of\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n has been shown to be highest in Africa and Asia, recent studies have also shown considerable burden in the Americas. With several pediatric\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n vaccines in clinical development, policymakers in the region will eventually consider whether a\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n vaccine is appropriate for their setting.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a systematic review and meta-analyses to summarize the burden (characterized by prevalence, incidence, and attributable fraction estimates) of\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n diarrhea among children under 72 months in the Americas, excluding the U.S., Canada, and Greenland. We searched published and pre-print articles available in six databases from January 1, 2000 through July 18, 2024. Random effects meta-analyses were conducted for subgroups of interest when relevant data from at least two studies were present.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This review included 34 studies conducted across 14 countries in the region. Prevalence was most frequently reported, followed by incidence, then attributable fraction. Across all prevalence studies that used a culture detection method (n\u2009=\u200923), the pooled prevalence of\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n among diarrhea cases was 3.1% (95% CI: 1.6- 5.8). The pooled prevalence among 7 studies that used PCR\/qPCR detection methods was 16.5% (95% CI: 11.1-24.0). Among culture-based results, the pooled prevalence estimate for children <12 months was 1.0% (95% CI: 0.1 \u2013 7.7) compared to 4.6% (95% CI: 1.2 \u2013 15.4) for children \u226512 months.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Despite varying reporting practices, we found\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n to be an important contributor to diarrhea in many settings in the Americas with substantial heterogeneity. Limited geographic representation and variable reporting of age group specific estimates were the major gaps in data. Investment in\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n surveillance in the Americas using a standardized methodology can contribute to accelerating\n \n Shigella<\/jats:italic>\n <\/jats:italic>\n vaccine development in consideration of regional preferences and optimal age of introduction.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013393","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:55:26Z","timestamp":1755539726000},"page":"e0013393","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Burden of Shigella among children with diarrhea in the Americas: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8659-5943","authenticated-orcid":true,"given":"Maya","family":"Lubeck-Schricker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea C.","family":"Rivas-Nieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Rosauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Mpinganjira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Bastias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Rogawski McQuade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Kosek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio F.","family":"Lanata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Paredes Olortegui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa J.","family":"Ochoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Platts-Mills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Vannice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0051-9131","authenticated-orcid":true,"given":"Patricia B.","family":"Pavlinac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"pntd.0013393.ref001","unstructured":"GBD Results. 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