Shigellosis in children less than five years in urban slum area: a study at primary health care in Jakarta

Background Shigellosis has a global distribution especially in countries with poor hygiene and sanitation. The most common manifestation of shigellosis in children is diarrhea with broad spectrum manifestations from watery diarrhea to classical dysentery. Appropriate antibiotic management is important to eradicate Shigella spp. Objective To find out shigellosis prevalence and manifestations and also Shigella spp. resistance pattern in children less than 5 years with acute diarrhea in certain district urban slum areas in Jakarta. Methods This cross sectional study involved 475 outpatients of less than 5 years old with acute diarrhea who visited primary health cares in Jakarta from July– October 2005. Stool for culture and antibiotic resistance test was taken with single rectal swab. Results Shigella spp. was found only in 3 (0.6%) patients. The subjects were between 6 to 24 months. Watery diarrhea was found in 1 subject and so was the classical dysentery manifestation of fever and bloody diarrhea. Two strains were found, 2 cases of S. sonnei and 1 case of S. flexneri. They were resistance to cotrimoxazole, tetracycline, and colistine. Conclusion Shigella spp. was not the main cause of acute diarrhea in children less than 5 years old. Due to the small number of cases, we could not find the most common manifestation and resistance pattern of shigellosis in these children