rare exposures. This lack of power resulted in relatively
imprecise estimates, indicated by wide confidence intervals
for some exposures. A further limitation of our study was the
un-blinded status of the investigator visiting the households
and conducting interviews to the case/control status of the
participant. This knowledge could have introduced bias in the
data collection, although the agreement of our findings with
earlier studies suggests otherwise.
Our study findings suggest a clear message for three areas
in which interventions to prevent shigellosis should be concentrated.
Firstly, there should be a provision of safe water,
sanitation, and fly control in all households. Water in the
latrine and garbage disposal should be improved. The avoidance
of dumping or burning rubbish around the household and
the control of flies in the household should be essential steps
in the future prevention of shigellosis. Secondly, the promotion
of hygiene, especially hand washing, suggests that
effective health messages may be provided through schools.
Thirdly, breastfeeding should be promoted to all mothers
with young children.