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Background  Diarrheal disease still remains a major public health threat and is often associated with fatal outcome especially in children with shigellosis mostly in developing countries. This study aimed to determine the presence of any associations between drinking shallow tube well (STW) water and childhood shigellosis. A total of 1394 children aged 0–59 months who presented with moderate-to-severe diarrhea (MSD) in Kumudini Women’s Medical College and Hospital, Bangladesh, from December 2007 to March 2011 were enrolled into the study.    Results  Among the study children, STW users often represented poor families (44% vs. 37%,  p  = 0.010); less often had household electricity (60% vs. 68%,  p  = 0.001) and cemented floor material (12% vs. 21%,  p  < 0.001); washed hand before eating (79% vs. 84%,  p  = 0.020); and had  Shigella sonnei  infections (7.8% vs. 13.1,  p  = 0.002) compared to deep tube well (DTW) water families (in bivariate analysis). After adjusting for covariates, a significant negative association was observed between childhood MSD episodes due to  Shigella sonnei  infections and the use of STW water (aOR 0.53, 95% CI 0.36, 0.79).    Conclusions  An emergence of less severe  Shigella sonnei  has replaced relatively more severe  Shigella flexneri  among the MSD children from DTW-user families. However, more monitoring in terms of disease surveillance for changes in the distribution of  Shigella  serogroups and serotypes and its upsurges and antimicrobial susceptibility is essential.

tropical medicine and health

Relation of childhood diarrheal morbidity with the type of tube well used and associated factors of Shigella sonnei diarrhea in rural Bangladesh site of the Global Enteric Multicenter Study