ArticleThe Lancet. Global health2023
Potential impact and cost-effectiveness of Shigella vaccination in 102 low-income and middle-income countries in children aged 5 years or younger: a modelling study.
Article in The Lancet. Global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 18 citations in OpenAlex.
- Burden of Shigella infection in children under five years living in a peri-urban area of Ouagadougou, Burkina Faso: A community-based cohort study.PLoS neglected tropical diseases · 2026Article
- Effects ofmedRxiv : the preprint server for health sciences · 2026Article
- Vaccine Candidates Designed to Prevent Enterotoxigenic Escherichia coli Diarrhoea: A Scoping Review of Clinical Trials Evaluating Vaccine Candidates in Development.Tropical medicine & international health : TM & IH · 2026Article
- Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review.PLOS global public health · 2026Article
- The Feeding Patterns as a Dominant Factor in the Occurrence of Stunting in Toddlers in Ponorogo.Journal of nutrition and metabolism · 2026Article
- Cumulative Incidence of Dysentery Among Under-Five Children in Underprivileged Urban Areas of Bhopal: A One-Year Cohort Study.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2025Article
- Reconstructing the Antibiotic Pipeline: Natural Alternatives to Antibacterial Agents.Biomolecules · 2025Review
- Safety, Tolerability, and Immunogenicity of the InvaplexVaccines · 2025Article
- Immunogenicity evaluation of altSonflex1-2-3Frontiers in immunology · 2025Article
- The 2022 Vaccines Against Shigella and Enterotoxigenic Escherichia coli (VASE) Conference: Summary of breakout workshops.Vaccine · 2024Article
- Optimizing Vaccine Trials for Enteric Diseases: The Enterics for Global Health (EFGH)Open forum infectious diseases · 2024Article
- Monoclonal Antibodies as a Therapeutic Strategy against Multidrug-Resistant Bacterial Infections in a Post-COVID-19 Era.Life (Basel, Switzerland) · 2024Review
- Reassessing potential economic value and health impact of effectiveBulletin of the World Health Organization · 2024Article
- Pathogenicity and virulence ofVirulence · 2023Review
- ExploringVaccine: X · 2023Article
- Burden of diarrhea and antibiotic use among children in low-resource settings preventable by Shigella vaccination: A simulation study.PLoS medicine · 2023Article
- Projecting the long-term economic benefits of reducing Shigella-attributable linear growth faltering with a potential vaccine: a modelling study.The Lancet. Global health · 2023Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundVaccine impact and cost-effectiveness models have mostly focused on acute burden. Shigella-attributable moderate-to-severe diarrhoea has been shown to be associated with childhood linear growth faltering. Evidence also links less severe diarrhoea to linear growth faltering. As Shigella vaccines are in late stages of clinical development, we aimed to estimate the potential impact and cost-effectiveness of vaccination against Shigella burden that includes stunting and the acute burden attributable to less severe diarrhoea and moderate-to-severe diarrhoea.
methodsWe used a simulation model to estimate Shigella burden and potential vaccination in children aged 5 years or younger from 102 low-income to middle-income countries from 2025 to 2044. Our model included stunting associated with Shigella-related moderate-to-severe diarrhoea and less severe diarrhoea and we explored vaccination impact on health and economic outcomes.
findingsWe estimate 109 million (95% uncertainty interval [UI] 39-204) Shigella-attributable stunting cases and 1·4 million (0·8-2·1) deaths in unvaccinated children over 20 years. We project that Shigella vaccination could avert 43 million (13-92) stunting cases and 590 000 (297 000-983 000) deaths over 20 years. The overall mean incremental cost-effectiveness ratio (ICER) was US$849 (95% uncertainty interval 423-1575; median $790 [IQR 635-1005]) per disability-adjusted life-year averted. Vaccination was most cost-effective in the WHO African region and in low-income countries. Including the burden of Shigella-related less severe diarrhoea improved mean ICERs by 47-48% for these groups and substantially improved ICERs for other regions.
interpretationOur model suggests that Shigella vaccination would be a cost-effective intervention, with a substantial impact in specific countries and regions. Other regions could potentially benefit upon the inclusion of the burden of Shigella-related stunting and less severe diarrhoea in the analysis.
fundingBill & Melinda Gates Foundation and Wellcome Trust.
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Registered trials
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