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

Authors: DEBLAIS, LOIC - The Ohio State University; OJEDA, AMANDA - University Of Florida; BRHANE, MUSSIE - Ethiopia Haramaya University; MUMMED, BAHAR - Ethiopia Haramaya University; HASSEN, KEDIR - Ethiopia Haramaya University; AHMEDO, BELISA - Ethiopia Haramaya University; WELDESENBET, YENENESH - Ethiopia Haramaya University; AMIN, JAFER - Ethiopia Haramaya University; AHMED, IBSA - Ethiopia Haramaya University; USMANE, IBSA - Ethiopia Haramaya University; YUSUF, EFRAH - Ethiopia Haramaya University; SERAN, ADABIR - Ethiopia Haramaya University; ABRAHIM, FAYO - Ethiopia Haramaya University; GAME, HALENGO - Ethiopia Haramaya University; MUMMED, BALLO - Ethiopia Haramaya University; USMAIL, MERI - Ethiopia Haramaya University; UMER, KUNUZA - Ethiopia Haramaya University; DAWID, MAWARDI - Ethiopia Haramaya University; GEBREYES, WONDWOSSEN - The Ohio State University; FRENCH, NIGEL - Massey University; HASSEN, JEMAL - Ethiopia Haramaya University; ROBA, KEDIR - Ethiopia Haramaya University; MOHAMMED, ABDULMUEN - Ethiopia Haramaya University; YIMER, GATNET - The Ohio State University; SALEEM, CYRUS - University Of Florida; CHEN, DEHAO - University Of Florida; SINGH, NITYA - University Of Florida; MANARY, MARK - Washington University; MCKUNE, SARAH - University Of Florida; HAVELAAR, ARIEH - University Of Florida; RAJASHEKARA, GIREESH - The Ohio State University

Submitted to: Applied and Environmental Microbiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/22/2023
Publication Date: 6/13/2023
Citation: Deblais, L., Ojeda, A., Brhane, M., Mummed, B., Hassen, K.A., Ahmedo, B.U., Weldesenbet, Y.D., Amin, J.K., Ahmed, I.A., Usmane, I.A., Yusuf, E.A., Seran, A.J., Abrahim, F.I., Game, H.T., Mummed, B.A., Usmail, M.M., Umer, K.A., Dawid, M.M., Gebreyes, W., French, N., Hassen, J.Y., Roba, K.T., Mohammed, A., Yimer, G., Saleem, C., Chen, D., Singh, N., Manary, M.J., McKune, S.L., Havelaar, A., Rajashekara, G. 2023. 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. Applied and Environmental Microbiology. https://doi.org/10.1128/aem.00424-23.
DOI: https://doi.org/10.1128/aem.00424-23

Interpretive Summary: Campylobacter infections in infants have been shown to be highly widespread in rural eastern Ethopia and are linked with gut health and stunting. A longitudinal study was conducted in this area, collecting stool samples from infants, household members, livestock, and environmental sources to gauge the frequency found and identify potential sources of Campylobacter. An age-dependent increase in Campylobacter frequency in infant stool samples as well as positive links with mother stool samples and soil collected inside the house suggests potential spread routes within households. This information may guide future interventions and strategies to reduce the impact of such infections in this population.

Technical Abstract: In our previous cross-sectional study, multiple species of Campylobacter were detected (88%) in stool samples from children (12 to 14 months of age) in rural eastern Ethiopia. This study assessed the temporal fecal carriage of Campylobacter in infants and identified putative reservoirs associated with these infections in infants from the same region. The prevalence and load of Campylobacter were determined using genus-specific real-time PCR. Stool samples from 106 infants (n = 1,073) were collected monthly from birth until 376 days of age (DOA). Human stool samples (mothers and siblings), livestock feces (cattle, chickens, goats, and sheep), and environmental samples (soil and drinking water) from the 106 households were collected twice per household (n = 1,644). Campylobacter was most prevalent in livestock feces (goats, 99%; sheep, 98%; cattle, 99%; chickens, 93%), followed by human stool samples (siblings, 91%; mothers, 83%; infants, 64%) and environmental samples (soil, 58%; drinking water, 43%). The prevalence of Campylobacter in infant stool samples significantly increased with age, from 30% at 27 DOA to 89% at 360 DOA (1% increase/day in the odds of being colonized) (P<0.001). The Campylobacter load increased linearly (P<0.001) with age from 2.95 logs at 25 DOA to 4.13 logs at 360 DOA. Within a household, the Campylobacter load in infant stool samples was positively correlated with the load in mother stool samples (r2 = 0.18) and soil collected inside the house (r2 = 0.36), which were in turn both correlated with Campylobacter loads in chicken and cattle feces (0.60 < r2 < 0.63) (P < 0.01). In conclusion, a high proportion of infants are infected with Campylobacter in eastern Ethiopia, and contact with the mother and contaminated soil may be associated with early infections.