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Meta-Analysis
. 2019 Jul 9;18(1):22.
doi: 10.1186/s12941-019-0321-1.

Prevalence of Shigella species and its drug resistance pattern in Ethiopia: a systematic review and meta-analysis

Siraj Hussen  1 , Getamesay Mulatu  2 , Zemenu Yohannes Kassa  3
Affiliations
Meta-Analysis

Prevalence of Shigella species and its drug resistance pattern in Ethiopia: a systematic review and meta-analysis

Siraj Hussen et al. Ann Clin Microbiol Antimicrob. .

Abstract

Background: Shigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of infectious disease. The aim was to conduct a systematic review and meta-analysis of Shigella species and its drug resistance pattern in Ethiopia.

Methods: A comprehensive literature search was conducted through internet searches using database of MEDLINE, PubMed, Google scholar, EMBASE, HINARI, Cochrane Library and reference lists of previous prevalence studies from January 1999 to November 2018. Results were presented in forest plot, tables and figures with 95% CI. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The Pooled estimate of Shigella species and its drug resistance pattern was computed by a random effects model.

Results: The pooled prevalence of Shigella species in Ethiopia was 6.6% (95% CI 4.7-8.8). In the subgroup analysis, the highest prevalence was observed among patients in Health facility (8.5%, 95% CI 6.2-11.5) whereas the lowest prevalence was observed in Community based studies (1.6%, 95% CI 0.8-3.4). In addition, Shigella species were highly resistant to ampicillin, amoxicillin, erythromycin and multi-drug resistant (MDR) with the pooled resistance proportions of 83.1% (95% CI 75.7-88.6), 84.1% (95% CI 75.6-90.1), 86.5% (95% CI 70.9-94.4) and 83.2% (95% CI 77.1-87.9), respectively. On the other hand, comparably low resistance pattern was reported for ciprofloxacin 8.9% (95% CI 6.0-12.8), ceftriaxone 9.3% (95% CI 3.9-20.5), and norfloxacin 8.2% (95% CI 3.8-16.6) and gentamycin 17.3% (95% CI 11.2-25.9). Subgroup analyses indicated that study years were associated with a decreasing Shigella prevalence over time (p = 0.002).

Conclusion: The pooled estimate showed high burden of Shigella infection and its high proportion of drug resistance pattern to ampicillin, amoxicillin and erythromycin in Ethiopia. Therefore, initiating and scale up of performing drug susceptibility test for each shigellosis case, educate the community and health care providers on appropriate use of antibiotics need to be considered and strengthened.

Keywords: Ethiopia; Meta-analysis; Prevalence; Resistance; Shigella species; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of studies reviewed, screened and included
Fig. 2
Fig. 2
Funnel plot for the prevalence of Shigella species in Ethiopia
Fig. 3
Fig. 3
Forest plot for the prevalence of Shigella species in Ethiopia
See this image and copyright information in PMC

References

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