Background. Shigellosis is the most common cause of epidemic dysentery found worldwide, particularly in developing countries, where it causes infant diarrhea and mortality. The prevalence of Shigella species resistant to commonly used antimicrobial drugs has steadily increased. The purpose of this review is to describe the prevalence and antimicrobial resistance (AMR) characteristics of Shigella species in East Africa between 2015 and 2022. Methods. Studies were identified using a computerized search of Medline/PubMed, Google Scholar, and Web of Science databases, with a detailed search strategy and cross-checking of reference lists for studies published between 2015 and 2022. Articles presenting data on prevalence and AMR, accessibility of the full-length article, and publication dates between 2015 and 2022 were the eligibility criteria for inclusion in the review. Original research reports written in English were considered. The heterogeneities of the studies were examined, and a meta-analysis was performed to estimate the pooled prevalence and AMR using a random effects model. Results. The pooled prevalence of Shigella species in East Africa was 6.2% (95% CI −0.20–12.60), according to an analysis of 22 studies. Shigella species prevalence was 4.0% in Ethiopia, 14.6% in Kenya, 0.7% in Sudan, 5.2% in South Sudan, and 20.6% in Somalia. The association of Shigella infection significantly varied among the countries ( ). Among the antibiotics tested, most Shigella isolates were susceptible to ciprofloxacin, norfloxacin, nalidixic acid, and ceftriaxone. Despite the fact that the reports varied in study sites and time, Shigella species were resistant to tetracycline, ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole. Conclusion. The pooled estimate indicates high burden of Shigella infection in East Africa, as well as a high proportion of drug resistance pattern to tetracycline, ampicillin, chloramphenicol, and amoxicillin. Therefore, initiating and scale-up of performing drug susceptibility test for each shigellosis case need to be considered and strengthened.

Background. Shigella and parasitic infections are common public health problems throughout the world. Shigellosis is an acute gastroenteritis infection and one of Ethiopia’s most common causes of morbidity and mortality, especially in children under five. High resistance rates to commonly used antibiotic agents have been documented in different locations in Ethiopia. Objective. This study aimed to characterize the antimicrobial features of the Shigella species isolated from children under five years of age with acute diarrhea in Addis Ababa, Ethiopia. Methods. Using a cross‐sectional study, freshly passed fecal specimens were collected for intestinal parasite and bacterial isolation. Fecal samples for bacterial identification were placed immediately in Cary–Blair media and transported to the Ethiopian Public Health Institution (EPHI) laboratory. Antimicrobial susceptibility testing (AMST) was conducted using the disk diffusion method. Data were described using descriptive statistical tools. The association of independent and dependent variables was evaluated with logistic regression. A P value ≤0.05 was considered statistically significant. Results. The prevalence of intestinal parasites was 8.2% with seven different species. Among the 534 stool‐cultured specimens, 47 (8.8%) were positive for Shigella species. Antimicrobial susceptibility testing (AMST) showed that 100%, 93.6%, 80.9%, 72.3%, and 57.5% were susceptible to norfloxacin, nalidixic acid, ciprofloxacin, gentamicin, and cefoxitin, respectively. However, 100% of the isolates were resistant to amoxicillin and erythromycin. More than 50% of the isolates were resistant to three and above antibiotics, while none of them were susceptible to all the antibiotics tested. All risk factors assessed did not show a statistically significant association with Shigella infection. Conclusion. The high levels of antibiotic resistance observed among the commonly prescribed antibiotics are alarming. The emerging resistance to ciprofloxacin and nalidixic acid signals a severe public health threat in the management of shigellosis. Raising awareness about resistance and educating health professionals, policymakers, and the public can help improve the quality of patient care and rational antibiotic use.

Background: In developing nations, Shigella species are the leading cause of epidemic dysentery, especially among children under five. Antibiotic resistance has spread quickly among Shigella species as a result of inappropriate antibiotic use, inadequacies of diagnostic facilities, unhygienic conditions, and insufficient healthcare practices. This review aimed to describe AMR genes of Shigella species analyzed globally via whole genome sequencing (WGS). Methods: Relevant papers were found via a literature search using the databases of Google Scholar, Web of Science, PubMed, and Scopus. Full-text primary studies published in English, WGS, Shigella serogroup, and AMR gene statistics had to be included in the articles. The comprehensive meta-analysis software was used for data analysis. The Der Simonian–Laird random effect model was utilized and statistical heterogeneity between studies is measured by the I ² and Cochran’s Q test. Results: Of the studies, resistant genes of S. flexneri was more studied and characterized. The overall prevalence of antibiotics resistance genes was in the range of 1.7% to 46.9% with gyrA S83 L was the most frequent isolated revealed this gene as predominant in the quinolones resistant gene of S. sonnei. It was followed by mphA (resistant to macrolides) for S. flexneri, and sul2 (resistant to folate synthesis inhibitors) for S. dysenteriae and S. boydii . Pooled prevalence of AMR gene in Shigella species significantly varied among the studies (p = 0.001). There was no significant amount of heterogeneity in S. bodyii (Q (4)) =1.938. p = 0.747, I ² = 0%) however in S. flexneri (I ² = 63%) and S. sonnei (I ² = 84%) showed high heterogeneity within the studies. Conclusion: Generally, there was considerable variation in the pooled prevalence of the AMR gene in Shigella species among the studies, with S. flexneri and S. sonnei showing the highest levels of heterogeneity. The effectiveness of treatment is seriously threatened by Shigella’s resistance to antibiotics. Therefore, it is imperative that Shigella species resistance be continuously monitored globally.

Background: Shigellosis is an acute gastroenteritis infection and one of Ethiopia’s most common causes of morbidity and mortality, especially in children under five. Antimicrobial resistance (AMR) has spread quickly among Shigella species due to inappropriate antibiotic use, inadequacies of diagnostic facilities, and unhygienic conditions. This study aimed to characterize Shigella sonnei (S. sonnei) using whole genome sequence (WGS) analysis in Addis Ababa, Ethiopia. Methods: The raw reads were quality-filtered and trimmed, and a minimum length of 50bp was retained and taxonomically classified using MiniKraken version 1. The whole genome data were aligned with Antibiotic Resistance Gene (ARG) sequences of the Comprehensive Antibiotic Resistance Database (CARD) by Resistance Gene Identifier (RGI). Plasmids were analyzed using the PlasmidFinder tool version 2.1. Additionally, AMR and virulence genes were screened at the Centre for Genomic Epidemiology (CGE) web-based server. Results: All isolates in our investigation contained genes encoding blaEC-8 and blaZEG-1. Here, 60.7% of the isolates were phenotypically sensitive to cefoxitin among the blaEC-8 genes detected in the genotyping analysis, whereas all isolates were completely resistant to amoxicillin and erythromycin phenotypically. The study also identified genes that conferred resistance to trimethoprim (dfrA). Plasmid Col156 and Col (BS512) types were found in all isolates, while IncFII and Col (MG828) plasmids were only identified in one isolate. Conclusion: This study found that many resistant genes were present, confirming the high variety in S. sonnei strains and hence a divergence in phylogenetic relationships. Thus, combining WGS methods for AMR prediction and strain identification into active surveillance may be beneficial for monitoring the spread of AMR in S. sonnei and detecting the potential emergence of novel variations.

Background: Obstetric violence is an emerging health problem in the utilization of maternal health services. In the study context, there was limited evidence on obstetric violence. Hence, the aim of this study was to assess obstetric violence and its associated factors among HIV-positive women who received birth care at public health facilities, in Addis Ababa, Ethiopia. Results: A total of 318 HIV-positive women participated in this study, yielding a 100% response rate. In this study, 79% of the HIV-positive women reported that they had been subjected to at least one form of obstetric violence during birth care. The top three reported forms of obstetric violence were as follows: 249 (78.3%) failed to provide informed consent, 227 (71.4%) did not complete medical procedures and 140 (44%) did not suffer life-threatening complications. The multivariable logistic regression analysis revealed that female birth status (AOR= 2.85; 95% CI 1.57, 5.15), fewer than three ANC visits (AOR= 2.99; 95% CI 1.39, 6.45), age >35 years old (AOR= 2.47; 95% CI 1.25, 4.90) and primary school attendance (AOR= 2.13; 95% CI 1.08, 4.17) were significantly associated with obstetric violence. This study revealed a high prevalence of obstetric violence among HIV -positive women. Hence, mitigation needs to be undertaken by taking the reported forms of obstetrics obstetric violence, and socio-demographic and obstetric variables by ensuring a systematic and strategic intervention for quality birth care utilization through the involvement of families, communities, the government and stakeholders.

Obstetric violence is an emerging health problem in maternal health services utilization. In the study context, there was limited evidence on obstetrics vi