134 research outputs found

    The ratio of <i>S</i>. <i>sonnei</i> to <i>S</i>. <i>flexneri</i> isolated from 100 countries, 1990–2014.

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    <p>The darker the color, the higher the proportion of <i>S</i>. <i>sonnei</i> isolated from each country; the lighter the color, proportionally higher the proportion of <i>S</i>. <i>flexneri</i> isolated. Countries colored grey indicate no data on species were identified. To generate this map, we performed an extensive literature review in PubMed using the term “<i>Shigella</i>” followed by the name of 178 countries. The most recent publication that included species information that was nonoutbreak and nontravel associated was included as representative of each country. If country data were pre-1990 or were not available on PubMed, the Gideon Infectious Disease encyclopedia as well as national reference laboratory data were referenced where possible. References are listed by country in the supplementary material (<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003708#pntd.0003708.s001" target="_blank">S1 Table</a>).</p

    Summary of factors behind the traditional and current epidemiological distribution of <i>S</i>. <i>sonnei</i> and <i>S</i>. <i>flexneri</i>.

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    <p>Summary of factors behind the traditional and current epidemiological distribution of <i>S</i>. <i>sonnei</i> and <i>S</i>. <i>flexneri</i>.</p

    Antimicrobial resistance and presence of resistance-conferring genes in <i>S</i>. <i>sonnei</i> and <i>S</i>. <i>flexneri</i>.

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    <p>Plots on the left show proportion of antimicrobial resistance determined by minimum inhibitory concentration (MIC) amongst isolates collected from Vietnam over a 15-year period (<i>n</i> = 231 for <i>S</i>. <i>sonnei</i> and 136 for <i>S</i>. <i>flexneri</i>) [<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003708#pntd.0003708.ref034" target="_blank">34</a>,<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003708#pntd.0003708.ref056" target="_blank">56</a>]. <i>S</i>. <i>sonnei</i> are shown by darker colors on the top of each graph, and <i>S</i>. <i>flexneri</i> is shown by lighter colors at the bottom. Plots on the right show the proportion of <i>S</i>. <i>sonnei</i> (dark color, top of each graph) and <i>S</i>. <i>flexneri</i> (light color, bottom of each graph) found to have varying resistance genes present on either plasmids or the chromosome. See <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003708#sec011" target="_blank">Supporting Information</a> (SI) <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003708#pntd.0003708.s002" target="_blank">S1 Text</a> for a description of procedures. The color of the gene corresponds with the color of the antimicrobial to which it confers resistance on the left. AMP: ampicillin; CHL: chloramphenicol; CIP: ciprofloxacin; CRO: ceftriaxone; GAT: gatifloxacin; GEN: gentamicin; NAL: nalidixic acid; OFX: ofloxacin; SXT: cotrimoxazole; TET: tetracycline; TMP: trimethoprim.</p

    Combined impact of sanitation and vaccination on the projected weekly incidence of typhoid.

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    <p>The model-predicted weekly number of typhoid cases in Vellore is plotted for values of the proportion of transmission due to chronic carriers (<i>c<sub>p</sub></i>) from 5% to 95% and the percent of transmission that is water-borne (<i>R</i><sub>0,<i>w</i></sub>/<i>R</i><sub>0</sub>) from 25% to 100%. Improved sanitation is modeled as a reduction in water-borne transmission (<i>R</i><sub>0,<i>w</i></sub>) from baseline levels to zero over a 30-year period beginning in year 5. Vaccination is introduced in year 5 with 80% coverage as routine vaccination of 6 year olds plus a one-time catch-up campaign among 6–15 year olds using ViPS vaccines. The red line represents the overall effect of sanitation plus vaccination, while the light blue line represents the effect of improved sanitation only and the dotted blue line is the projected typhoid incidence in the absence of any intervention.</p

    Overall effect of vaccination on the projected incidence of typhoid over the first 10 years following vaccine introduction.

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    <p>The model-predicted reduction in the cumulative incidence of typhoid at coverage levels ranging from 0 to 100% is plotted for vaccine-induced immunity and efficacy assumptions corresponding to (<i>A</i>) the Ty21a live oral vaccine, (<i>B</i>) the Vi-polysaccharide (ViPS) vaccine, and (<i>C</i>) the Vi-conjugate (ViCV) vaccine administered at 6 years of age or (<i>D</i>) 9 months of age. The red line represents the model-predicted overall effect of vaccination, while the green line represents the population direct effect of vaccination. The dotted black line represents the population coverage (i.e. the proportion of the population ever vaccinated).</p

    Model for the transmission dynamics of typhoid.

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    <p>(<i>A</i>) Diagram of model structure. Model parameters are defined in <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002642#pntd-0002642-t001" target="_blank">Table 1</a>. (<i>B</i>) Weekly incidence of observed (blue line) and model-predicted (thick red line) typhoid inpatients at Christian Medical College hospital in Vellore, India. The thin red line represents a simulated incidence time-series for the best-fit model assuming the number of cases each week is Poisson distributed with a mean equal to the model-predicted incidence. (<i>C</i>) Age distribution of observed (blue) and model-predicted (red) typhoid cases.</p

    Predicted impact of vaccination on the weekly incidence of typhoid.

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    <p>Vaccination is introduced in year 5 with 80% coverage as (<i>A</i>) a one-time campaign among 6–15 year olds, (<i>B</i>) routine vaccination of 6 year olds, or (<i>C</i>) routine vaccination of 6 year olds plus a one-time catch-up campaign among 6–15 year olds. The red line represents the model-predicted overall effect of vaccination, while the green line represents the population direct effect of vaccination and the dotted blue line is the projected typhoid incidence in the absence of vaccination.</p

    The distribution of <i>S.</i> Typhi MIC to ofloxacin in seven RCTs.

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    <p>Histogram showing the distribution of <i>S.</i> Typhi MICs (<0.06, 0.06, 0.125, 0.25, 0.5 and 1 µg/mL) to ofloxacin over seven individual randomised. The proportion of <i>S.</i> Typhi strains with the corresponding MIC are shaded accordingly, white; study TY1 (1992–1993) n = 19 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Smith2" target="_blank">[25]</a>, very light grey; study CT1 (1993–1994) n = 102 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Vinh1" target="_blank">[26]</a>, light grey; study TY2 (1993–1996) n = 103 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Nguyen1" target="_blank">[24]</a>, mid grey; study DTC (1994–1995) n = 154 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Vinh2" target="_blank">[28]</a>, dark grey; study DN (1995–1996) n = 55 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Cao1" target="_blank">[29]</a>, very dark grey; study TY3 (1997–1998) n = 45 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Chinh1" target="_blank">[23]</a> and black; study DTY2 (1998–2001) n = 62 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001163#pntd.0001163-Parry3" target="_blank">[27]</a>.</p
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