a look back at an ongoing problem shigella dysenteriae type 1 epidemics in refugee settings in central africa (1993–1995)回顾一个持续存在的问题志贺痢疾杆菌i型)的流行病在中部非洲难民设置(1993 - 1995).pdfVIP

A Look Back at an Ongoing Problem: Shigella dysenteriae Type 1 Epidemics in Refugee Settings in Central Africa (1993–1995) ´ 1 1 2,3 4 1 Solen Kerneis , Philippe J. Guerin *, Lorenz von Seidlein , Dominique Legros , Rebecca F. Grais 1 Epicentre, Paris, France, 2 Joint Malaria Programme, Tanga, Tanzania, 3 London School of Hygiene and Tropical Medicine, Wellcome Trust Unit, Bangkok, Thailand, 4 Disease Control in Humanitarian Emergencies, Epidemic and Pandemic Alert and Response, WHO, Geneva, Switzerland Abstract Background: Shigella dysenteriae type 1 (Sd1) is a cause of major dysentery outbreaks, particularly among children and displaced populations in tropical countries. Although outbreaks continue, the characteristics of such outbreaks have rarely been documented. Here, we describe the Sd1 outbreaks occurring between 1993 and 1995 in 11 refugee settlements in Rwanda, Tanzania and Democratic Republic of the Congo (DRC). We also explored the links between the different types of the camps and the magnitude of the outbreaks. Methodology/Principal Findings: Number of cases of bloody diarrhea and deaths were collected on a weekly basis in 11 refugee camps, and analyzed retrospectively. Between November 1993 and February 1995, 181,921 cases of bloody diarrhea were reported. Attack rates ranged from 6.3% to 39.1% and case fatality ratios (CFRs) from 1.5% to 9.0% (available for 5 camps). The CFRs were higher in children under age 5. In Tanzania where the response was rapidly deployed, the mean attack rate was lower than in camps in the region of Goma without an immediate response (13.3% versus 32.1