Shigellosis is the principal cause of clinical dysentery and a frequent cause of morbidity and mortality in children in impoverished regions. Due to the rapid spread of multiple antibiotic resistant strains and the lack of an available vaccine the morbidity and mortality from shigellosis is likely to increase worldwide. In the initial period of IRSDA support the determination of age-specific incidence rates of shigellosis, risk factors for disease development, antibiotic resistance profiles and regional serotype data to define the burden of drug resistant Shigella and serotype distribution of isolates in a highly endemic area was completed. ERIC-PCR was compared to the gold standard PFGE for the molecular typing of a subset of isolates and was found to be have a nearly equal discriminatory index to PFGE and was simpler, faster, and more affordable therefore more appropriate for use in endemic areas. Isolates from sentinel children under longitudinal surveillance and their contacts studied in a nested case control study to determine the mode of interfamilial spread was limited by the low yield of cultures. The identification of Shigella nearly exclusively by PCR in environmental sources including flies, drinking water, surface waters, and hand washings necessitate the identification and evaluation of a typing method that does not require primary isolation by culture to fully understand the transmission dynamics of shigellosis. The present supplemental application will address the relevance of these sources using a combined approach including PCR detection, epidemiologic analysis of the risk of proximity to these PCR positive but culture negative sources and a space-time analysis of sources of infection in order to optimally understand the ecology and transmission dynamics of this important pathogen. The collaborative research group that is assembled to conduct this study is an established international group of epidemiologists, physicians, biostatisticians, and molecular biologists with a proven track record in the training of junior scientists in an international setting. The proposed project will further strengthen these international research ties in the process of the continued training of a promising physician-scientist.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01TW005717-05
Application #
7125956
Study Section
Special Emphasis Panel (ZRG1-ICP-2 (51))
Program Officer
Jessup, Christine
Project Start
2001-09-29
Project End
2008-08-31
Budget Start
2006-09-01
Budget End
2007-08-31
Support Year
5
Fiscal Year
2006
Total Cost
$102,600
Indirect Cost
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Lee, Gwenyth O; Paredes Olortegui, Maribel; Salmón-Mulanovich, Gabriela et al. (2016) Early child health in an informal settlement in the Peruvian Amazon. BMC Int Health Hum Rights 16:26
Lee, Gwenyth; Paredes Olortegui, Maribel; Peñataro Yori, Pablo et al. (2014) Effects of Shigella-, Campylobacter- and ETEC-associated diarrhea on childhood growth. Pediatr Infect Dis J 33:1004-9
Lee, Gwenyth; Pan, William; Peñataro Yori, Pablo et al. (2013) Symptomatic and asymptomatic Campylobacter infections associated with reduced growth in Peruvian children. PLoS Negl Trop Dis 7:e2036
Lee, Gwenyth; Yori, Pablo; Olortegui, Maribel Paredes et al. (2012) Comparative effects of vivax malaria, fever and diarrhoea on child growth. Int J Epidemiol 41:531-9
Kosek, Margaret; Yori, Pablo P; Gilman, Robert H et al. (2012) High degree of Plasmodium vivax diversity in the Peruvian Amazon demonstrated by tandem repeat polymorphism analysis. Am J Trop Med Hyg 86:580-6
Kosek, Margaret; Yori, Pablo Penataro; Gilman, Robert H et al. (2012) Facilitated molecular typing of Shigella isolates using ERIC-PCR. Am J Trop Med Hyg 86:1018-25
Kosek, Margaret; Yori, Pablo Peñataro; Olortegui, Maribel Paredes (2010) Shigellosis update: advancing antibiotic resistance, investment empowered vaccine development, and green bananas. Curr Opin Infect Dis 23:475-80
Yori, Pablo Penataro; Schwab, Kellogg; Gilman, Robert H et al. (2009) Norovirus highly prevalent cause of endemic acute diarrhea in children in the peruvian Amazon. Pediatr Infect Dis J 28:844-7
Kosek, Margaret; Yori, Pablo Penataro; Pan, William K et al. (2008) Epidemiology of highly endemic multiply antibiotic-resistant shigellosis in children in the Peruvian Amazon. Pediatrics 122:e541-9
Matson, Ryan; Rios, Carlos Tong; Chavez, Cesar Banda et al. (2008) Improved molecular technique for the differentiation of neotropical anopheline species. Am J Trop Med Hyg 78:492-8

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