Risk factors for shigellosis in Thailand.

Abstract

OBJECTIVES:

To assess the potential risk factors for shigellosis including housefly density.

METHODS:

A matched case-control study to investigate potential risk factors for shigellosis was conducted in a semi-urban area, Kaengkhoi District, Saraburi Province, central Thailand. Shigella cases were ascertained from a two-year population-based surveillance study detecting diarrhea and shigellosis in the area. The study evaluated a wide range of exposures, which were assessed by odds ratios (OR) adjusted for proxy markers of socioeconomic status: family income, and type of residence, using conditional logistic regression analysis.

RESULTS:

Hygiene behaviors such as regular hand washing (p<0.05), a clean environment surrounding the household (p<0.001), and the availability of water to flush the toilet (p=0.08) were associated with a reduced risk for shigellosis in the multivariate model. In contrast factors indicating a lower than average socioeconomic status, such as having to rent instead of owning one's housing (p<0.001) and a low family income (p<0.01) were associated with an increased risk for shigellosis. For children, breastfeeding showed a strong protective effect in reducing the risk of shigellosis (p<0.01). Prior to adjustment for environmental factors, fly density in the kitchen area was associated with an increased risk of shigellosis (p<0.01).

CONCLUSIONS:

We found a correlation between socioeconomic status and the risk for shigellosis. To reduce shigellosis in this setting, we recommend interventions focused on three aspects: improved water supply and sanitation (especially latrines and garbage disposal) including fly control, health education on hand washing, and the promotion of breastfeeding.

• Authors: Pornthip Chompook, Jim Todd, Jeremy G Wheeler, Lorenz von Seidlein, John Clemens, Wanpen Chaicumpa
• Journal: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 10 Issue 6 Pg. 425-33 (Nov 2006) ISSN: 1201-9712 [Print] Canada
• PMID: 16997593 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Animals
• Breast Feeding
• Case-Control Studies
• Diptera
• Dysentery, Bacillary (prevention & control)
• Hand
• Housing
• Humans
• Hygiene
• Population Density
• Population Surveillance
• Poverty
• Risk Factors
• Sanitation
• Thailand (epidemiology)
• Water Supply (standards)