Ruminant-Related Risk Factors are Associated with Shiga Toxin–Producing Escherichia coli Infection in Children in Southern Ghana

Abstract

Livestock can provide benefits to low-income households, yet may expose children to zoonotic enteropathogens that cause illness and negative long-term health outcomes. The aim of this cross-sectional study was to determine whether livestock-related risk factors, including animal ownership, exposure to animal feces, and consumption of animal-source foods, were associated with bacterial zoonotic enteropathogen infections in children 6–59 months old in Greater Accra, Ghana. Stool samples from 259 children and 156 household chickens were analyzed for atypical enteropathogenic Escherichia coli (aEPEC), Campylobacter jejuni/coli (C. jejuni/coli), Salmonella, and Shiga toxin–producing Escherichia coli (STEC) using quantitative polymerase chain reaction (qPCR). aEPEC, C. jejuni/coli, STEC, and Salmonella were detected in 45.6%, 11.6%, 4.3%, and 0.8% of children’s stool samples, respectively. In adjusted logistic regression models, household ownership of goats or sheep was associated with STEC detection in children (odds ratio [95% confidence interval {CI}]: 4.30 [1.32, 14.08]), as were positive detection of STEC in chicken feces (7.85 [2.54, 24.30]) and frequent consumption of fresh cow’s milk (3.03 [1.75, 5.24]). No livestock-related risk factors were associated with aEPEC or C. jejuni/coli infection in children. Our findings suggest that ruminant ownership in southern Ghana may expose children to STEC through household fecal contamination and foodborne routes. The lack of association between livestock risk factors and the more commonly detected pathogens, aEPEC and C. jejuni/coli, warrants further research, particularly to help explain how animal-keeping and sanitation practices affect transmission of fecal pathogens that were highly prevalent in chicken feces.

Associations of bacterial enteropathogens with systemic inflammation, iron deficiency, and anemia in preschool-age children in southern Ghana

“…This approach is consistent with other similar studies that have investigated associations between infections and biological parameters, such as iron status [29] or EED biomarkers [46]. While sample selection was stratified based on household chicken ownership, owning chickens was not associated with enteropathogen detection in children [35]. As a sensitivity analysis, we used adjusted linear regression to model associations between enteropathogen detection and the outcomes of interest as continuous variables (i.e., CRP, AGP, SF, sTfR, and Hb concentrations).…”

“…Of those with a stool sample, a subsample of 265 children (62%) was selected for analysis due to the financial constraints of conducting enteropathogen testing. Based on an associated study investigating whether chicken ownership and detection of pathogenic bacteria in chickens' feces was associated with enteropathogen infection in children [35], this 265-child subsample comprised all 163 children from chickenowning households and 102 of 267 children (38%) from a random sample of non-chicken owning households. Children included in the subsample were not significantly different in sex or age from those who were excluded.…”

Integrating climate change, food safety, nutrition, and health outcomes in food systems policies and programs in Africa

“…Additionally, E. coli was found on leafy vegetables among farming households in Ethiopia, Addis Ababa (Ali et al, 2023), as well as in cattle, beef, and humans in Central Ethiopia (Gutema et al, 2021). It was also detected among children in Southern Ghana (Lambrecht et al, 2022).…”

The Planetary Child Health & Enterics Observatory (Plan-EO): A protocol for an interdisciplinary research initiative and web-based dashboard for mapping enteric infectious diseases and their risk factors and interventions in LMICs

“…Classification of materials used in the construction of the floor, roof, and walls of the dwelling in which the child resides Natural; Rudimentary; Finished [89] Livestock husbandry Household ownership of livestock by species category Poultry; Monogastric; Ruminant [90] Sanitation facility Presence and type of sanitation facility used by the child's household [87] None (open defecation); Unimproved; Sewer or septic tank; Other improved [46] https://doi.org/10.1371/journal.pone.0297775.t003…”