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

Authors: HAVELAAR, ARIE - University Of Florida; BRHANE, MUSSIE - Ethiopia Haramaya University; AHMED, IBSA - Ethiopia Haramaya University; KEDIR, JAFER - Ethiopia Haramaya University; CHEN, DEHAO - University Of Florida; DEBLAIS, LOIC - University Of Florida; FRENCH, NIGEL - Massey University; GEBREYES, WONDWOSSEN - The Ohio State University; HASSEN, JEMAL - Ethiopia Haramaya University; LI, XIAOLONG - University Of Florida; MANARY, MARK - Washington University; MEKURIA, ZELEALEM - The Ohio State University; IBRAHIM, ABDULMUEN - Ethiopia Haramaya University; MUMMED, BAHAR - Ethiopia Haramaya University; OJEDA, AMANDA - University Of Florida; RAJASHEKARA, GIREESH - The Ohio State University; ROBA, KEDIR - The Ohio State University; SALEEM, CYRUS - University Of Florida; SINGH, NITYA - University Of Florida; USMANE, IBSA - Ethiopia Haramaya University; YANG, YANG - University Of Florida; YIMER, GETNET - The Ohio State University; MCKUNE, SARAH - University Of Florida

Submitted to: BMJ Open
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/4/2022
Publication Date: 10/26/2022
Citation: Havelaar, A.H., Brhane, M., Ahmed, I.A., Kedir, J., Chen, D., Deblais, L., French, N., Gebreyes, W.A., Hassen, J.Y., Li, X., Manary, M.J., Mekuria, Z., Ibrahim, A.M., Mummed, B., Ojeda, A., Rajashekara, G., Roba, K.T., Saleem, C., Singh, N., Usmane, I.A., Yang, Y., Yimer, G., McKune, S. 2022. Unravelling the reservoirs for colonisation of infants with Campylobacter spp. in rural Ethiopia: Protocol for longitudinal study during a global pandemic and political tensions. BMJ Open. 12(10). Article e061311. https://doi.org/10.1136/bmjopen-2022-061311.
DOI: https://doi.org/10.1136/bmjopen-2022-061311

Interpretive Summary: Animal-source foods can be used to decrease malnutrition in children under five, however livestock are important source for Campylobacter bacteria which can be harmful to children. This study aims to identify sources of Campylobacter infection in infants in rural Eastern Ethiopia and gauge their relations with child health, specifically gut health and stunting, within their sociodemographic environment. The study involves infants followed from birth to 12 months of age, collecting questionnaire-based information on many things and studying stool samples from infants, mothers, siblings, livestock, drinking water, and soil using microbiological methods. We aim to create an institutional environment, ensuring that smallholder livestock production and associated risk of EED receive the attention and investment this problem deserves.

Technical Abstract: Undernutrition 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. This 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, iblings 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.