DOI: 10.5061/dryad.nvx0k6f38
title: Supplementary material from: Burden of Shigella among children with diarrhea in the Americas: A systematic review and meta-analysis

description: Introduction: Shigella infection is a leading cause of diarrhea
 worldwide. While the burden of Shigella has been shown
 to be highest in Africa and Asia, recent studies have also shown
 considerable burden in the Americas. With several
 pediatric Shigella vaccines in clinical development,
 policymakers in the region will eventually consider whether
 a Shigella vaccine is appropriate for their
 setting.  Methods: We conducted a systematic review and
 meta-analyses to summarize the burden (characterized by prevalence,
 incidence, and attributable fraction estimates)
 of Shigella diarrhea among children under 72 months in
 the Americas, excluding the U.S., Canada, and Greenland. We searched
 published and pre-print articles available in six databases from January
 1, 2000 through July 23, 2024. Random effects meta-analyses were conducted
 for subgroups of interest when relevant data from at least two studies
 were present. Results: This review included 34 studies conducted across 14
 countries in the region. Prevalence was most frequently reported, followed
 by incidence, then attributable fraction. Across all prevalence studies
 that used a culture detection method (n=23), the pooled prevalence
 of Shigella among diarrhea cases was 3.1% (95% CI: 1.6-
 5.8). The pooled prevalence among 12 studies that used PCR/qPCR detection
 methods was 16.5% (95% CI: 11.1-24.0). Among culture-based results, the
 pooled prevalence estimate for children &lt;12 months was 1.0% (95%
 CI: 0.1 – 7.7) compared to 4.6% (95% CI: 1.2 – 15.4) for children ≥12
 months. Conclusion: Despite varying reporting practices, we
 found Shigella to be an important contributor to
 diarrhea in many settings in the Americas with substantial heterogeneity.
 Limited geographic representation and variable reporting of age group
 specific estimates were the major gaps in data. Investment
 in Shigella surveillance in the Americas using a
 standardized methodology can contribute to accelerating Shigella
 vaccine development in consideration of regional preferences and optimal
 age of introduction.
description: # Supplementary material from: Burden of Shigella among children with
 diarrhea in the Americas: A systematic review and meta-analysis
 [https://doi.org/10.5061/dryad.nvx0k6f38](https://doi.org/10.5061/dryad.nvx0k6f38) ## Description of the data and file structure This file contains supplementary material for a systematic review titled *Burden of Shigella among Children with Diarrhea in the Americas: A Systematic Review and Meta-Analysis.* We conducted a systematic review and meta-analyses to summarize the burden (characterized by prevalence, incidence, and attributable fraction estimates) of *Shigella* diarrhea among children under 72 months in the Americas, excluding the U.S., Canada, and Greenland. We searched published and pre-print articles available in six databases from January 1, 2000 through July 23, 2024. Random effects meta-analyses were conducted for subgroups of interest when relevant data from at least two studies were present. ### Files and variables The figures file contains all tables and figures mentioned in the manuscript. The appendices file contains the following information: * Appendix 1: PRISMA 2020 Checklist for Systematic Reviews * Appendix 2: Database Search Strings * Appendix 3: Adapted Joanna Briggs Institute (JBI) Quality Assessment Tool * Appendix 4: Quality Assessment of Included Studies * Appendix 5: Additional forest plots of *Shigella* burden * Appendix 6: Burden Estimates from Study Sites in the Amazon Region * Appendix 7: Reference List of Studies Included in this Review The included studies data file contains the following information regarding all studies included in the review: * DOI/Link - The digital location where the included study was accessed * Publication Language - The language of the original publication * Title (English) - The title of the study (translated to English, when relevant) * Lead author last name - The last name of only the first author * Year of publication - Year in which the study was published * Data collection start - The date (month then year) when the study commenced data collection * Data collection end - The date (month then year) when the study finished data collection * Study site (country) - The country/countries where the study took place, if &gt;2 listed as "multiple countries" ## Access information Data was derived from the following sources: See Appendix 7 for reference list