The incidence and antimicrobial resistance of Shigella-attributable diarrhoea in young children in low-income and middle-income countries from the multicountry Enterics for Global Health (EFGH) Shigella Surveillance Study: a prospective, facility-based hybrid surveillance study

BACKGROUND: Shigella is a leading cause of dysentery and watery diarrhoea in low-income and middle-income countries (LMICs) with consequences beyond diarrhoea for children younger than 5 years, including environmental enteric dysfunction and linear growth impairment. We established the burden, serotypes, and antibiotic resistance patterns of Shigella-diarrhoea among young children in LMICs to inform vaccine trial planning and eventual vaccine introduction in high-burden countries. METHODS: The Enterics for Global Health (EFGH) study was a prospective, facility-based hybrid surveillance study conducted from June 21, 2022, to Aug 25, 2024, across seven countries: Kenya, Malawi, Mali, The Gambia, Bangladesh, Pakistan, and Peru. Children aged 6-35 months presenting at selected health-care facilities with acute diarrhoea (three or more abnormally loose or watery stools in…