Trend and disease burden of dysentery in zambia 2016-2018

Introduction Dysentery is bloody diarrhoea, i.e. any diarrhoeal episode in which the loose or watery stools contain visible red blood. Dysentery is most often caused by Shigella species (bacillary dysentery) or Entamoeba histolytica (amoebic dysentery) [1]. Over the past years, Dysentery has not stimulated public fear in the same way that Cholera has. Nonetheless, the disease can be extremely dangerous as it has the potential to affect a number of people in a short period of time. Just like Cholera, the disease is transmitted through ingestion of food or water that has been contaminated by the feces of a human carrier of the infective organism and can spread at a very fast rate. If not properly managed, Dysentery caused by Shigella dysenteriae type 1 (Sd1) can have a case fatality of up to 10% or more [2]. The disease has been recurrent in some parts of the world and is highly associated with high mortality in children [3]. Children below the age of 5 years and malnourished people [4] are mostly affected and are at a high risk of dying due to dysentery [5]. In 2015, Diarrhea diseases accounted for over 1.3 million deaths globally [6]. Dysentery caused by Shigella species (S. flexneri, S. sonnei, S. boydii, and S. dysenteriae) remains a major source of diarrhea in most developing countries. In Africa, one of the earliest documented Dysentery cases caused by Sd1 was recorded in Burundi in 1943 [7]. Since then, Dysentery has remained a major public health problem in Sub-Saharan countries. In the 1980s, Rwanda and the Democratic Republic of Congo (DRC) recorded devastating dysentery cases that saw the community incidence of 5 % to 6.4%. Since 1991, dysentery epidemics have occurred in eight countries in southern Africa (Angola, Burundi, Malawi, Mozambique, Rwanda, Tanzania, Zaire, and Zambia) [8]. In 1992, Zimbabwe was hit by dysentery outbreaks which affected almost all the provinces. However, 149 dysentery patients died (CFR 3%) out of 4 915 patients that presented themselves to two municipal hospitals [9]. A number of factors such as overcrowding and poor water and hygiene infrastructure [10], limited access to improved water supplies and sanitation facilities [11] are some of the prominent factors that contribute to dysentery outbreaks. Globally, contaminated water causes millions and millions of cases of dysentery every year [12]. In Zambia, there is little documentation and studies that have been done on dysentery. However, a few papers that have been done show that inter house sharing of latrines [13] and contact with a person who has dysentery are some of the risk factors to the spread of the disease. This paper presents dysentery trend analysis results analyzed from the Integrated Disease Surveillance and Response (IDSR) database.