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Many different bacteria, viruses, and parasites can cause diarrhea. Sometimes diarrhea is just uncomfortable, sometimes it’s deadly. In fact, in many countries in Africa and Asia, diarrhea is a major cause of death in children. If a child’s diarrhea is caused by some types of bacteria, Shigella, for instance, things can get pretty bad. Shigella is a leading cause of morbidity (the rate of disease in a population) and mortality (the number of deaths due to a disease) among children worldwide. Some countries don’t have the ability to test for Shigella, so doctors rely only on symptoms to diagnose it and to see if antibiotic treatment is needed. We wanted to check if the method recommended by the World Health Organization (WHO) – looking for blood in children’s stool – really identifies Shigella-infected children. We found that it doesn’t – only a small proportion of children with Shigella had blood in their stool. We, therefore, recommend using a different method to determine which children with diarrhea need antibiotic treatment

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