The Enterics for Global Health (EFGH) Shigella surveillance study employs cross-sectional and longitudinal study designs to establish incidence and consequences of medically attended Shigella diarrhea in children 6-35 months of age in each of the EFGH study sites (Bangladesh, The Gambia, Kenya, Malawi, Mali, Pakistan, Peru). Through this multi-country surveillance network and associated standardization of protocols and procedures, selected EFGH sites will be ready to quickly implement rigorous and efficient vaccine trials, accelerating the time to vaccine availability to children in low- and middle-income countries.

Children 6-35 of age presenting with diarrhea at selected study health facilities will be recruited over a 24-month period and followed for 3 months. A hybrid surveillance approach will be used to estimate the incidence rate of medically-attended Shigella diarrhea at EFGH sites through enrollment of eligible diarrhea cases, estimation of the underlying 6-35 month population, and adjustment for care-seeking behavior. Through follow-up visits, data on clinical and anthropometric outcomes from Shigella diarrhea, cost to families and health care systems, and immune response will be established.