Geospatial Analysis of Multilevel Socio-environmental Factors Impacting theCampylobacterBurden Among Infants in Rural Eastern Ethiopia: A One Health Perspective

Abstract

Increasing attention has focused on health outcomes ofCampylobacterinfections among children under five years in low-resource settings. Recent evidence suggests colonization ofCampylobacterspecies contributes to environmental enteric dysfunction, malnutrition, and growth faltering in young children.Campylobacterspecies are zoonotic, and factors from humans, animals, and the environment are involved in transmission. Few studies have assessed geospatial effects of environmental factors along with human and animal factors onCampylobacterinfections. Here, we leveragedCampylobacterGenomics and Environmental Enteric Dysfunction (CAGED) project data to model multiple socio-environmental factors onCampylobacterburden among infants in Eastern Ethiopia. Stool samples from 106 infants were collected monthly from birth through the first year of life (December 2020 – June 2022). Genus-specific Taqman real-time PCR was performed to detect and quantifyCampylobacterspp. and calculate cumulativeCampylobacterburden for each child as the outcome variable. Thirteen regional environmental covariates describing topography, climate, vegetation, soil, and human population density were combined with household demographics, livelihoods/wealth, livestock ownership, and child-animal interactions as explanatory variables. We dichotomized all continuous outcome and explanatory variables and built logistic regression models for the first and second half of the infant’s first year of life. Infants being female, living in households with cattle, reported to have physical contact with animals, or reported to have mouthed soil or animal feces had increased odds of higher cumulativeCampylobacterburden in Eastern Ethiopia. Future interventions should focus on infant-specific transmission pathways and create adequate separation of domestic animals from humans to prevent potential fecal exposures.