Unravelling the reservoirs for colonisation of infants with Campylobacter spp. in rural Ethiopia: protocol for a longitudinal study during a global pandemic and political tensions

Abstract

IntroductionUndernutrition is an underlying cause of mortality in children under five (CU5) years of age. Animal-source foods have been shown to decrease malnutrition in CU5. Livestock are important reservoirs for Campylobacter bacteria, which are recognised as risk factors for child malnutrition. Increasing livestock production may be beneficial for improving nutrition of children but these benefits may be negated by increased exposure to Campylobacter and research is needed to evaluate the complex pathways of Campylobacter exposure and infection applicable to low-income and middle-income countries. We aim to identify reservoirs of infection with Campylobacter spp. of infants in rural Eastern Ethiopia and evaluate interactions with child health (environmental enteric dysfunction and stunting) in the context of their sociodemographic environment.Methods and analysisThis longitudinal study involves 115 infants who are followed from birth to 12 months of age and are selected randomly from 10 kebeles of Haramaya woreda, East Hararghe zone, Oromia region, Ethiopia. Questionnaire-based information is obtained on demographics, livelihoods, wealth, health, nutrition and women empowerment; animal ownership/management and diseases; and water, sanitation and hygiene. Faecal samples are collected from infants, mothers, siblings and livestock, drinking water and soil. These samples are analysed by a range of phenotypic and genotypic microbiological methods to characterise the genetic structure of the Campylobacter population in each of these reservoirs, which will support inference about the main sources of exposure for infants.Ethics and disseminationEthical approval was obtained from the University of Florida Internal Review Board (IRB201903141), the Haramaya University Institutional Health Research Ethics Committee (COHMS/1010/3796/20) and the Ethiopia National Research Ethics Review Committee (SM/14.1/1059/20). Written informed consent is obtained from all participating households. Research findings will be disseminated to stakeholders through conferences and peer-reviewed journals and through the Feed the Future Innovation Lab for Livestock Systems.

Prevalence and Load of the Campylobacter Genus in Infants and Associated Household Contacts in Rural Eastern Ethiopia: a Longitudinal Study from the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) Project

“…Human stool samples (infants, siblings, and mothers), livestock feces (cattle, chickens, goats, and sheep), and environmental samples (drinking water and soil) were collected between December 2020 and June 2022. Additional details about the population size for each kebele and sample type are included in Table S1 in the supplemental material ( 29 ).…”

“…One of the objectives of our longitudinal study was to investigate the prevalence and load of Campylobacter in stool samples collected from 106 infants from eastern Ethiopia during the first 376 days after birth. To ensure that the data presented in this study are representative of the studied region, several selection criteria were used, which were described in great detail previously ( 29 ). Briefly, our study focused on 106 households distributed across 10 of the 36 rural kebeles from the Haramaya woreda (synonym for district) ( 29 ).…”

“…To ensure that the data presented in this study are representative of the studied region, several selection criteria were used, which were described in great detail previously ( 29 ). Briefly, our study focused on 106 households distributed across 10 of the 36 rural kebeles from the Haramaya woreda (synonym for district) ( 29 ). This area was of special interest because the Haramaya woreda harbors a high rate of stunting (45.8%) compared to the national average (38%) ( 29 , 30 ).…”

“…Based on these findings, a longitudinal study was conducted with 106 selected households between December 2020 and June 2022 in the same region in rural eastern Ethiopia. The overall objectives and study design were reported previously ( 29 ). The objectives of this specific study were to assess the patterns of the temporal colonization of infants with Campylobacter and to identify potential reservoirs associated with Campylobacter infections in infants from rural eastern Ethiopian households.…”

Examining the role of women’s engagement in khat production on child nutritional outcomes using longitudinal data in East Oromia, Ethiopia

“…The CAGED study was designed to assess the fecal-oral transmission network of Campylobacter bacteria in Haramaya woreda, East Hararghe zone, Oromia region, Ethiopia, and to quantify the role of livestock, humans, and other reservoirs in this transmission. The study aims, research questions, and detailed methodology are published elsewhere [65], though an overview is briefly described below. This study was approved by the Institutional Review Board of the University of Florida, the Institutional Health Research Ethics Committee of Haramaya University, and the Ethiopia National Research Ethics Review Committee.…”