Volume 11, Issue Supplement_1, March 2024

This article describes the background and rationale for the Enterics for Global Health (EFGH) study, a multi-country surveillance study aimed at optimizing the design and implementation of pivotal Shigella vaccine trials.

This article describes the epidemiologic methods used in the Enterics for Global Health Shigella surveillance study, a multicountry surveillance network that aims to establish current Shigella diarrhea incidence and consequence estimates and prepare potential clinical trial sites for a phase 3 vaccine trial.

The Enterics for Global Health (EFGH): Shigella Surveillance Study will utilize a hybrid surveillance design to characterize population denominators and healthcare-seeking behavior to calculate Shigella diarrhea incidence rates in children aged 6 to 35 months across sites in Africa, Asia, and Latin America.

This article describes the standardization and implementation of optimal microbiological methods for the isolation and identification of Shigella in the Enterics for Global Health study. Isolation of Shigella from whole stool versus rectal swabs and the use of different transport media are compared.

Shigella spp, Shigella flexneri serotypes, and other diarrhea-associated enteropathogens are detected and quantified with a customized real-time polymerase chain reaction–based TaqMan Array Card in the Enterics for Global Health: Shigella surveillance study. Shigella burden will be estimated with a quantitative methodology.

The Enterics for Global Health (EFGH) Shigella surveillance study will estimate the cost per episode of medically attended Shigella diarrhea across 7 countries to inform policy decisions about potential investments in preventive strategies.

This paper describes the data management systems and processes employed by the Enterics for Global Health: Shigella Surveillance Study (EFGH). Systems and procedures were designed to promote equity in access and decision-making while maintaining high-quality data standards.

Multiplex bead-based immunoassays for IgG to conserved and type-specific Shigella antigens will be performed on acute and convalescent dried blood spots to characterize conserved and type-specific immune responses and validate molecular identification of type-specific Shigella diarrhea.

Fecal inflammatory biomarkers may accurately identify bacterial diarrheal episodes, which could inform antibiotic treatment decisions. Prior research was limited by using insensitive diagnostics. We will evaluate 4 inflammatory biomarkers in stool from children with diarrhea in the EFGH study.

This article describes the Enterics for Global Health (EFGH) Bangladesh site, including the features of facility-based disease surveillance, population enumeration, healthcare utilization survey, and capacity-building initiatives for junior investigators for the EFGH study and future Shigella vaccine trials.

This article describes The Gambia EFGH study site, research capacities, study catchment area, and recruitment facilities. This paper also highlights sociodemographic status, healthcare-seeking behaviors for diarrhea, diarrheal case management, antibiotic resistance patterns, and new vaccine adaptation in children.

A diarrhea-specific research platform able to perform population-based enumeration and hospital-based surveillance plus support mentorship of young scientists has been established in western Kenya to support Enterics for Global Health–Shigella surveillance and future vaccine trials.

Malawi is participating in the Enterics for Global Health (EFGH) study to determine the incidence of diarrhea attributed to Shigella in children aged <5 years. This article describes the study site in Ndirande Township, Blantyre, Malawi.

CVD-Mali has developed an infrastructure that enables detailed investigations of diarrheal diseases among infants and young children in Mali to inform the development of effective interventions. The results from EFGH will inform the conduct trials with promising vaccine candidates.

This paper describes the country profile, terrain, health indicators, healthcare seeking and management of diarrheal disease. Pakistan is one of the consortium members in EFGH study and has high burden of childhood diarrheal diseases.

Loreto, Peru, has a high burden of shigellosis, diarrhea, and dysentery. The population is an appropriate one in which to study improved treatments or prevention strategies.