Early Childhood Shigellosis and Attention Deficit Hyperactivity Disorder: A Population-Based Cohort Study with a Prolonged Follow-up

Background: Although the short-term neurological complications ofShigellaspp. are well described, potential neuropsychiatric outcomes have not been studied yet. We investigated the association between early childhood shigellosis and subsequent ADHD. Methods: This is a retrospective population-based cohort. Using a large Health Maintenance Organization database, the prevalence of ADHD was investigated among children aged 5-18 years who underwent stool culture prior to the age of 3 years. Results: Of 52,761 children with a stool culture examined, 5,269 (9.98%) hadShigella-positive results. The rate of ADHD was 10.6% and 8.6% among children withShigella-positive andShigella-negative stool cultures, respectively (p< .001). Adjusted odds ratio for ADHD after controlling for gender and socioeconomic status was 1.21 (CI 1.13-1.29,p< .001). The younger the child was duringShigellagastroenteritis, the higher was the association with ADHD (p< .001). Conclusion: Early childhood shigellosis is associated with an increased rate of long-term ADHD.