Gut microbiome, enteric infections and child growth across a rural–urban gradient: protocol for the ECoMiD prospective cohort study

Abstract

IntroductionThe functional consequences of the bacterial gut microbiome for child health are not well understood. Characteristics of the early child gut microbiome may influence the course of enteric infections, and enteric infections may change the composition of the gut microbiome, all of which may have long-term implications for child growth and development.Methods and analysisWe are conducting a community-based birth cohort study to examine interactions between gut microbiome conditions and enteric infections, and how environmental conditions affect the development of the gut microbiome. We will follow 360 newborns from 3 sites along a rural–urban gradient in northern coastal Ecuador, characterising enteric infections and gut microbial communities in the children every 3 to 6 months over their first 2 years of life. We will use longitudinal regression models to assess the correlation between environmental conditions and gut microbiome diversity and presence of specific taxa, controlling for factors that are known to be associated with the gut microbiome, such as diet. From 6 to 12 months of age, we will collect weekly stool samples to compare microbiome conditions in diarrhoea stools versus stools from healthy children prior to, during and after acute enteric infections, using principal-coordinate analysis and other multivariate statistical methods.Ethics and disseminationEthics approvals have been obtained from Emory University and the Universidad San Francisco de Quito institutional review boards. The findings will be disseminated through conference presentations and peer-reviewed journals.

A Qualitative Study of Food Choice in Urban Coastal Esmeraldas, Ecuador

“…These interviews were nested within a cross-sectional pilot survey of 71 mother–child dyads. The primary objective of the cross-sectional pilot survey was to refine study instruments and protocols for the “Gut microbiome, enteric infections and child growth across a rural–urban gradient” birth cohort study [ 49 ]. The primary, a priori objective of the qualitative substudy was to better understand how urbanicity might drive household decision making around food for families with young children.…”

Characterizing Behaviors Associated with Enteric Pathogen Exposure among Infants in Rural Ecuador through Structured Observations

“…The Gut Microbiome, Enteric Infections, and Child Growth across a Rural-Urban Gradient or Enteropatogenos, Crecimiento, Microbioma y Diarrea (EcoMID) study is a prospective cohort study of infants living in northern Ecuador from birth to age 2 years. 36 One of the study's goals is to comprehensively characterize environmental enteropathogen exposures affecting young children through a combination of environmental microbiology, qualitative, survey-based, and structured observations methods.…”

The development and validation of a survey to measure fecal-oral child exposure to zoonotic enteropathogens: The FECEZ Enteropathogens Index

“…Our study was conducted in multiple communities in northwestern coastal Ecuador as part of an ongoing birth cohort study, Enteropatógenos, Crecimiento, Microbioma, y Diarrea (referred to as ECoMiD). [34] The EcoMiD study assesses the impact of environmental exposures on enteric pathogen infections, gut microbiome composition, and development during the first two years of children's lives. The region is primarily populated by Afro-Ecuadorians, mestizos, and some indigenous individuals.…”