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Mulu W, Joossens M, Kibret M, Van den Abeele AM, Houf K. Campylobacter occurrence and antimicrobial resistance profile in under five-year-old diarrheal children, backyard farm animals, and companion pets. PLoS Negl Trop Dis 2024; 18:e0012241. [PMID: 38833441 PMCID: PMC11178231 DOI: 10.1371/journal.pntd.0012241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/14/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.
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Affiliation(s)
- Wondemagegn Mulu
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Marie Joossens
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
| | - Mulugeta Kibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Anne-Marie Van den Abeele
- Laboratory of Microbiology, Sint-Lucas Hospital, Ghent, Belgium
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Kurt Houf
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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2
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Legge H, Kazungo K, Muli S, Elson L, Mwongeli J, Halliday KE, Ochwal V, Oswald W, Dreibelbis R, Njomo D, Mwandawiro C, Fillinger U, Pullan R, Kepha S. Identifying Potential Determinants of Faecal Contamination on Domestic Floors in Three Settings in Rural Kenya: A Mixed Methods Analysis. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241246454. [PMID: 38737960 PMCID: PMC11088304 DOI: 10.1177/11786302241246454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/21/2024] [Indexed: 05/14/2024]
Abstract
Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok). Quantitative data was collected through a household census and analysed descriptively and using mixed effects logistic regression models. Qualitative data was collected through unstructured observations of daily routines and in-depth interviews. These data were analysed thematically with case memos produced for routine activities that were hypothesised to be determinants of floor contamination. Possible proximal determinants of floor contamination included; (1) animal contact with floors; (2) child faeces disposal, and; (3) floor cleaning routines. Distal determinants are suggested to be rooted in the socioeconomic, environmental, and cultural context in which households were located and included; (1) the type and number of animals owned by households; (2) presence/absence of dedicated shelters for housing animals at night, which impacted whether sleeping or cooking areas were exposed to animals; (3) Accessibility of inside spaces to poultry and other roaming animals; (4) ownership of an improved floor; (5) ability of animals to access neighbours compounds; (6) seasonal changes in weather. These results will be of use in identifying the contexts in which faecal contamination of domestic floors may be contributing towards transmission of enteric and parasitic infections and in designing effective interventions to prevent this exposure.
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Affiliation(s)
- Hugo Legge
- London School of Hygiene & Tropical Medicine, UK
| | - Karisa Kazungo
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Sharon Muli
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Lynne Elson
- KEMRI-Wellcome Trust, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
| | - Jacinta Mwongeli
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | - Victoria Ochwal
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - William Oswald
- London School of Hygiene & Tropical Medicine, UK
- Global Health Division, International Development Group, RTI International, Research Triangle Park, NC, USA
| | | | - Doris Njomo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ulrike Fillinger
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | | | - Stella Kepha
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
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3
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Grace D, Knight-Jones TJD, Melaku A, Alders R, Jemberu WT. The Public Health Importance and Management of Infectious Poultry Diseases in Smallholder Systems in Africa. Foods 2024; 13:411. [PMID: 38338547 PMCID: PMC10855203 DOI: 10.3390/foods13030411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024] Open
Abstract
Poultry diseases pose major constraints on smallholder production in Africa, causing high flock mortality and economic hardship. Infectious diseases, especially viral diseases like Newcastle disease and highly pathogenic avian influenza (HPAI) and bacterial diseases, especially colibacillosis and salmonellosis, are responsible for most chicken losses, with downstream effects on human nutrition and health. Beyond production impacts, poultry diseases directly harm public health if zoonotic, can give rise to epidemics and pandemics, and facilitate antimicrobial resistance through treatment attempts. HPAI, campylobacteriosis, and salmonellosis are the priority zoonoses. Sustainable solutions for poultry health remain elusive despite recognition of the problem. This review summarises current knowledge on major poultry diseases in smallholder systems, their impacts, and options for prevention and control. We find biosecurity, vaccination, good husbandry, and disease-resistant breeds can reduce disease burden, but practical limitations exist in implementing these measures across smallholder systems. Treatment is often inefficient for viral diseases, and treatment for bacterial diseases risks antimicrobial resistance. Ethnoveterinary practices offer accessible alternatives but require more rigorous evaluation. Multisectoral collaboration and policies that reach smallholder poultry keepers are essential to alleviate disease constraints. Successful control will improve livelihoods, nutrition, and gender equity for millions of rural families. This review concludes that sustainable, scalable solutions for smallholder poultry disease control remain a critical unmet need in Africa.
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Affiliation(s)
- Delia Grace
- Natural Resources Institute (NRI), Chatham ME4 4TB, UK
- International Livestock Research Institute (ILRI), Nairobi P.O. Box 30709, Kenya
| | | | - Achenef Melaku
- Department of Veterinary Pharmacy, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Robyn Alders
- Development Policy Centre, Australian National University, Acton, Canberra 2601, Australia;
| | - Wudu T. Jemberu
- International Livestock Research Institute (ILRI), Addis Ababa P.O. Box 5689, Ethiopia or (W.T.J.)
- Department of Veterinary Epidemiology and Public Health, University of Gondar, Gondar P.O. Box 196, Ethiopia
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4
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Gutema FD, Cumming O, Mumma J, Simiyu S, Attitwa E, Okoth B, Denge J, Sewell D, Baker KK. Enterococcus contamination of infant foods and implications for exposure to foodborne pathogens in peri-urban neighbourhoods of Kisumu, Kenya. Epidemiol Infect 2024; 152:e23. [PMID: 38264955 PMCID: PMC10894905 DOI: 10.1017/s0950268824000062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
We collected infant food samples from 714 households in Kisumu, Kenya, and estimated the prevalence and concentration of Enterococcus, an indicator of food hygiene conditions. In a subset of 212 households, we quantified the change in concentration in stored food between a morning and afternoon feeding time. In addition, household socioeconomic characteristics and hygiene practices of the caregivers were documented. The prevalence of Enterococcus in infant foods was 50% (95% confidence interval: 46.1 - 53.4), and the mean log10 colony-forming units (CFUs) was 1.1 (SD + 1.4). No risk factors were significantly associated with the prevalence and concentration of Enterococcus in infant foods. The mean log10 CFU of Enterococcus concentration was 0.47 in the morning and 0.73 in the afternoon foods with a 0.64 log10 mean increase in matched samples during storage. Although no factors were statistically associated with the prevalence and the concentration of Enterococcus in infant foods, household flooring type was significantly associated with an increase in concentration during storage, with finished floors leading to 1.5 times higher odds of concentration increase compared to unfinished floors. Our study revealed high prevalence but low concentration of Enterococcus in infant food in low-income Kisumu households, although concentrations increased during storage implying potential increases in risk of exposure to foodborne pathogens over a day. Further studies aiming at investigating contamination of infant foods with pathogenic organisms and identifying effective mitigation measures are required to ensure infant food safety.
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Affiliation(s)
- Fanta D Gutema
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
- Department of Microbiology, Immunology and Veterinary Public health, Addis Ababa University, Bishoftu, Ethiopia
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Jane Mumma
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
| | - Sheillah Simiyu
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
- African Population and Health Research Center, Nairobi, Kenya
| | - Edwin Attitwa
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
| | - Bonphace Okoth
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
| | - John Denge
- Center of Research, Great Lakes University of Kisumu, Kisumu, Kenya
| | - Daniel Sewell
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Kelly K Baker
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA
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5
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Zerfu TA, Nguyen G, Duncan AJ, Baltenweck I, Brown F, Iannotti LL, McNeill G. Associations between livestock keeping, morbidity and nutritional status of children and women in low- and middle-income countries: a systematic review. Nutr Res Rev 2023; 36:526-543. [PMID: 36522652 DOI: 10.1017/s0954422422000233] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Livestock keeping can positively influence the nutritional status of populations and households through increased consumption of animal-source foods (ASF) and other indirect pathways, but can also adversely affect health by increasing the risk of diseases. We conducted a systematic review synthesising the current state of knowledge on the associations among livestock keeping, infectious disease and the nutritional status of children under 5 years and women of reproductive age in low- and lower-middle-income countries (LMICs). A comprehensive search of 12 electronic databases and grey literature sources published from 1991 to the end of December 2020 was conducted. Investigations exploring relationships between livestock keeping and risk of infectious disease transmission and nutritional status were selected using pre-defined inclusion criteria. After screening and filtering of 34,402 unique references, 176 references were included in the final synthesis. Most (160/176, 90.1%) of the references included in the final synthesis were from sub-Saharan Africa (SSA) and Asia. About two out of every five (42%) studies reviewed showed that livestock production is associated with improved height-for-age Z scores (HAZ) and weight-for-length/height Z scores (WHZ), while close to a third (30.7%) with improved weight-for-age Z scores (WAZ). Similarly, livestock production showed a positive or neutral relationship with women's nutritional status in almost all the references that reported on the topic. Conversely, four-fifths (66/81, 79.5%) of the references reporting on infection and morbidity outcomes indicated that livestock keeping is linked to a wide range of infectious disease outcomes, which are spread primarily through water, food and insects. In conclusion, in many LMIC settings, livestock production is associated with better nutritional outcomes but also a higher risk of disease transmission or morbidity among women and children.This review was prospectively registered on PROSPERO 2020 [CRD42020193622].
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Affiliation(s)
- Taddese Alemu Zerfu
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Giang Nguyen
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
| | - Alan J Duncan
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | | | - Fiona Brown
- Library and University Collections, Information Services, University of Edinburgh, Edinburgh, UK
| | - Lora L Iannotti
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Geraldine McNeill
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Edinburgh, UK
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6
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Lambrecht NJ, Müller-Hauser AA, Sobhan S, Schmidt WP, Huda TMN, Waid JL, Wendt AS, Kader A, Gabrysch S. Effect of a Homestead Food Production Program on the Prevalence of Diarrhea and Acute Respiratory Infection in Children in Sylhet, Bangladesh: A Cluster-Randomized Controlled Trial. Am J Trop Med Hyg 2023; 109:945-956. [PMID: 37580032 PMCID: PMC10551083 DOI: 10.4269/ajtmh.23-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/22/2023] [Indexed: 08/16/2023] Open
Abstract
Diarrhea and respiratory illness are leading causes of mortality and morbidity among young children. We assessed the impact of a homestead food production intervention on diarrhea and acute respiratory infection (ARI) in children in Bangladesh, secondary outcomes of the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized trial. The trial enrolled 2,705 married women and their children 3 years or younger in 96 rural settlements (geographic clusters) in Sylhet Division, Bangladesh. The intervention promoted home gardening and poultry rearing alongside child nutrition and health counseling over 3 years (2015-2018). An 8-month food hygiene behavior change component using emotional drivers was delivered beginning in mid-2017. Caregiver-reported diarrhea and symptoms of ARI in the week preceding the survey were recorded every 2 months. We analyzed 32,460 observations of 3,276 children over 4 years and found that 3.9% of children had diarrhea and 3.4% had an ARI in the prior 7 days. There was no overall effect of the intervention on 7-day diarrhea period prevalence (odds ratio [OR], 0.92; 95% CI, 0.71-1.19), diarrhea point prevalence (OR, 1.03; 95% CI, 0.78-1.36), or 7-day ARI period prevalence (OR, 1.18; 95% CI, 0.88-1.60). There was no impact on diarrhea severity or differences in health-seeking behaviors. Our findings suggest that this homestead food production program was insufficient to reduce morbidity symptoms among children in a rural setting. More comprehensive water, sanitation, and hygiene measures, and behavioral recommendations may be needed to achieve impacts on child health.
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Affiliation(s)
- Nathalie J. Lambrecht
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Berlin, Germany
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Anna A. Müller-Hauser
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Berlin, Germany
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Shafinaz Sobhan
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Berlin, Germany
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Wolf-Peter Schmidt
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tarique Md. Nurul Huda
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukairiyah, Saudi Arabia
- Environmental Interventions Unit, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jillian L. Waid
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Amanda S. Wendt
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
| | - Abdul Kader
- Bangladesh Country Office, Helen Keller International, Dhaka, Bangladesh
| | - Sabine Gabrysch
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Berlin, Germany
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, Potsdam, Germany
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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7
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Espira LM, Gessese B, Kassa BA, Wu CC, Riley J, Bedru S, Sahilu G, Desta A, Baye K, Jones AD, Love NG, Eisenberg JNS. Multiscalar Evaluation of the Water Distribution System and Diarrheal Disease Risk in Addis Ababa, Ethiopia. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:13313-13324. [PMID: 37642551 PMCID: PMC10501120 DOI: 10.1021/acs.est.2c08976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
Despite growing urbanization, our understanding of the impacts of water and sanitation on human health has largely come from studies in rural sectors. To this end, we collected data at both regional (water quality measures from water treatment systems) and community (cross-sectional surveys) scales to examine determinants of enteric pathogen infection and diarrheal disease among infants in Addis Ababa, Ethiopia. Regionally, the Legedadi water treatment plant had significantly lower heterotrophic plate counts, total coliform counts, and fecal coliform counts compared with the Gefersa water treatment plant. The number of pathogen types in infant stool also differed by plant. Decreases in chlorine levels and increases in the relative abundance of Gammaproteobacteria with distance from treatment plants suggest a compromised water distribution system. In communities, infants in households that obtained water from yard pipes or public taps had significantly lower odds of diarrhea compared to households that had water piped into their dwellings (OR = 0.35, 95% CI 0.16, 0.76, and OR = 0.39, 95% CI 0.15, 1.00, respectively). Similarly, infants in households that boiled or filtered water had significantly lower odds of diarrhea compared to households that did not treat water (OR = 0.40, 95% CI 0.19, 0.86 and OR = 0.23, 95% CI 0.06, 0.84, respectively). Integrating multiscalar data better informs the health impacts of water in urban settings.
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Affiliation(s)
- Leon M. Espira
- Department
of Epidemiology, University of Michigan
School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Brook Gessese
- Ethiopian
Institute of Water Resources, Addis Ababa
University, Addis
Ababa 150461, Ethiopia
| | - Bayable A. Kassa
- Institute
of Biotechnology, Addis Ababa University, Addis Ababa 1176, Ethiopia
| | - Chia-Chen Wu
- Institute
of Environmental Engineering, National Yang
Ming Chiao Tung University, Hsinchu City 30010, Taiwan
| | - Joshua Riley
- Department
of Civil and Environmental Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Seifedin Bedru
- School of
Civil and Environmental Engineering, Addis
Ababa University, Addis Ababa 1176, Ethiopia
| | - Geremew Sahilu
- School of
Civil and Environmental Engineering, Addis
Ababa University, Addis Ababa 1176, Ethiopia
| | - Adey Desta
- Department
of Microbial and Cellular Biology, Addis
Ababa University, Addis Ababa 1176, Ethiopia
| | - Kaleab Baye
- Center
for
Food Science and Nutrition, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa 1176, Ethiopia
| | - Andrew D. Jones
- Department
of Nutritional Sciences, University of Michigan
School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Nancy G. Love
- Department
of Civil and Environmental Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Joseph N. S. Eisenberg
- Department
of Epidemiology, University of Michigan
School of Public Health, Ann Arbor, Michigan 48109, United States
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8
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Deblais L, Ojeda A, Brhane M, Mummed B, Hassen KA, Ahmedo BU, Weldesenbet YD, Amin JK, Ahmed IA, Usmane IA, Yusuf EA, Seran AJ, Abrahim FI, Game HT, Mummed BA, Usmail MM, Umer KA, Dawid MM, Gebreyes W, French N, Hassen JY, Roba KT, Mohammed A, Yimer G, Saleem C, Chen D, Singh N, Manary MJ, McKune SL, Havelaar AH, Rajashekara G. 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. Appl Environ Microbiol 2023; 89:e0042423. [PMID: 37310259 PMCID: PMC10370295 DOI: 10.1128/aem.00424-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023] Open
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. IMPORTANCE A high Campylobacter prevalence during early childhood has been associated with environmental enteric dysfunction (EED) and stunting, especially in low-resource settings. Our previous study demonstrated that Campylobacter was frequently found (88%) in children from eastern Ethiopia; however, little is known about potential Campylobacter reservoirs and transmission pathways leading to infection of infants by Campylobacter during early growth. In the longitudinal study presented here, Campylobacter was frequently detected in infants within the 106 surveyed households from eastern Ethiopia, and the prevalence was age dependent. Furthermore, preliminary analyses highlighted the potential role of the mother, soil, and livestock in the transmission of Campylobacter to the infant. Further work will explore the species and genetic composition of Campylobacter in infants and putative reservoirs using PCR and whole-genome and metagenomic sequencing. The findings from these studies can lead to the development of interventions to minimize the risk of transmission of Campylobacter to infants and, potentially, EED and stunting.
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Affiliation(s)
| | - Amanda Ojeda
- University of Florida, Gainesville, Florida, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nigel French
- Massey University, Palmerston North, New Zealand
| | | | | | | | - Getnet Yimer
- Global One Health Initiative, The Ohio State University, Addis Ababa, Ethiopia
| | - Cyrus Saleem
- University of Florida, Gainesville, Florida, USA
| | - Dehao Chen
- University of Florida, Gainesville, Florida, USA
| | - Nitya Singh
- University of Florida, Gainesville, Florida, USA
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9
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Ballard AM, Laramee N, Haardörfer R, Freeman MC, Levy K, Caruso BA. Measurement in the study of human exposure to animal feces: A systematic review and audit. Int J Hyg Environ Health 2023; 249:114146. [PMID: 36868140 PMCID: PMC10044406 DOI: 10.1016/j.ijheh.2023.114146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/31/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Human exposure to animal feces is increasingly recognized as an important transmission route of enteric pathogens. Yet, there are no consistent or standardized approaches to measurement of this exposure, limiting assessment of the human health effects and scope of the issue. OBJECTIVE To inform and improve approaches to the measurement of human exposure to animal feces, we audited existing measurement in low- and middle-income countries. METHODS We systematically searched peer-reviewed and gray literature databases for studies with quantitative measures of human exposure to animal feces and we classified measures in two ways. First, using a novel conceptual model, we categorized measures into three 'Exposure Components' identified a priori (i.e., Animal, Environmental, Human Behavioral); one additional Component (Evidence of Exposure) inductively emerged. Second, using the exposure science conceptual framework, we determined where measures fell along the source-to-outcome continuum. RESULTS We identified 1,428 measures across 184 included studies. Although studies overwhelmingly included more than one single-item measure, the majority only captured one Exposure Component. For example, many studies used several single-item measures to capture the same attribute for different animals, all of which were classified as the same Component. Most measures captured information about the source (e.g. animal presence) and contaminant (e.g. animal-sourced pathogens), which are most distal from exposure on the source-to-outcome continuum. DISCUSSION We found that measurement of human exposure to animal feces is diverse and largely distal from exposure. To facilitate better assessment of the human health effects of exposure and scope of the issue, rigorous and consistent measures are needed. We recommend a list of key factors from the Animal, Environmental, and Human Behavioral Exposure Components to measure. We also propose using the exposure science conceptual framework to identify proximal measurement approaches.
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Affiliation(s)
- April M Ballard
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Nicholas Laramee
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Matthew C Freeman
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Bethany A Caruso
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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10
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Admasie A, Eshetu A, Tessema TS, Vipham J, Kovac J, Zewdu A. Prevalence of Campylobacter species and associated risk factors for contamination of dairy products collected in dry season from major milk sheds in Ethiopia. Food Microbiol 2022; 109:104145. [DOI: 10.1016/j.fm.2022.104145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
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11
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Lowe J, Ercumen A, Prottas C, Harris AR. Exploring the determinants and indicators of poultry feces management behaviors in rural Western Uganda. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155202. [PMID: 35421491 DOI: 10.1016/j.scitotenv.2022.155202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
Animal ownership has reported financial and nutritional benefits but has also been associated with enteric and respiratory infections, and inadequate sanitation and hygiene can lead to children touching and ingesting animal fecal matter. We identified key indicators for poultry feces management and investigated their social determinants using data from a baseline survey of a randomized-controlled trial of a poultry management training program in rural Western Uganda. The baseline survey was conducted in the Masindi and Kiryandongo districts of Uganda in September 2019, and data collected from 609 households were used. We evaluated indicators for poultry feces management behaviors using scale development methods, including descriptive statistics, bivariate correlation analyses, and Factor Analysis of Mixed Data. We also investigated social determinants of key poultry feces management behaviors using logistic and multinomial logistic regression models. A significant increase in odds of having free-roaming poultry was found for each additional poultry owned (OR = 1.18, P < 0.001). The odds of a household having an observed enclosure for poultry increased by 5% with each incremental poultry owned (OR = 1.05, P < 0.001), and by 4% with increasing wealth with each additional point on the poverty probability index score (OR = 1.04, P < 0.001). Our results also suggest enclosures are intermittently used and constructing them without further intervention likely will not be sufficient for effectively managing animal fecal contamination. We recommend that future studies on animal feces management measure indicators for corralling and feces disposal practices and evaluate their relationship to enteric pathogen exposure and health outcomes. Insights from this work can inform the development of robust indicators of poultry feces management behaviors that can be used for monitoring and evaluation purposes.
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Affiliation(s)
- Jeremy Lowe
- Department of Civil, Construction, and Environmental Engineering, NC State University, Raleigh, NC, United States.
| | - Ayse Ercumen
- Department of Forestry and Environmental Resources, NC State University, Raleigh, NC, United States.
| | | | - Angela R Harris
- Department of Civil, Construction, and Environmental Engineering, NC State University, Raleigh, NC, United States.
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12
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Nigusu Y, Abdissa A, Tesfaw G. Campylobacter Gastroenteritis Among Under-Five Children in Southwest Ethiopia. Infect Drug Resist 2022; 15:2969-2979. [PMID: 35706923 PMCID: PMC9191834 DOI: 10.2147/idr.s354843] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Under-five children are at an increased risk for foodborne illnesses because of the ingenuousness of their immune system. Although Campylobacter species are one of the bacterial etiologies of gastroenteritis, Campylobacter gastroenteritis among under-five children is not well considered in Ethiopia. Therefore, this study aimed at exploring the prevalence, associated risk factors, and antibiotic susceptibility patterns of Campylobacter species among under-five children with diarrhea. Methods The institution-based cross-sectional study was conducted among under-five children with diarrhea at Jimma Medical Center, southwestern Ethiopia from January 5 to April 21, 2020. Stool samples were collected and inoculated into Campylobacter agar medium. Isolation and identification were done using standard bacteriological techniques. Antibiotic susceptibility testing was conducted on Mueller-Hinton agar supplemented with 10% sheep blood using disk diffusion techniques. Bivariate and multivariate logistic regressions were used to assess the associated risk factors. Results A total of 214 under-five children were enrolled. The prevalence of Campylobacter infection was 8.9%. Absence of caretakers' handwashing before preparation of food [AOR = 3.7, 95% CI: (1.2-10.8)], direct contact with domestic animals [AOR = 3.6, 95% CI: (1.0-12.7)], and consumption of raw dairy products [AOR = 4.5, 95% CI: (1.4-13.9)] are the factors associated with Campylobacter infection. Some Campylobacter species were found to be resistant to most available antibiotics. Conclusion The magnitude of Campylobacter gastroenteritis indicates the need for routine isolation and identification of Campylobacter species from all under-five children clinically diagnosed with diarrhea. Species that are resistant to the drug of choice for Campylobacteriosis are also emerging. Health education on the importance of pasteurization of milk and caretakers' handwashing can mitigate the transmission. Mechanism of handling of domestic animals should be considered to reduce transmission of zoonotic diseases like Campylobacteriosis.
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Affiliation(s)
- Yared Nigusu
- Department of Medical Laboratory Science, College of Health Sciences, Mettu University, Mettu, Ethiopia,Correspondence: Yared Nigusu, Tel +251 921 20 46 63, Email ;
| | - Alemseged Abdissa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia,School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Getnet Tesfaw
- School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia
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13
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Molecular Survey and Identification of Campylobacter spp. in Layer Farms in Central Ethiopia. Trop Med Infect Dis 2022; 7:tropicalmed7020031. [PMID: 35202226 PMCID: PMC8876474 DOI: 10.3390/tropicalmed7020031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Few data are available on Campylobacter spp. presence in chickens in Ethiopia. Due to its importance for both the poultry sector and public health, a sampling activity was planned to evaluate Campylobacter spp. presence in layer farms in Bishoftu and Mojo, Central Ethiopia. Twenty cloacal pooled samples were collected and tested with molecular assays for detection and Sanger-sequenced for species identification. As a secondary aim, samples were also tested for Salmonella spp. by PCR, and all samples were negative. On the other hand, 70% of cloacal swab pools were positive for Campylobacter spp.: 71.4% of the positive samples belonged to C. jejuni species, 21.4% to C. avium and 7.1% to C. helveticus. Campylobacter spp. was identified in almost all farms regardless of farm and flock size, age and hybrid types of the birds and antimicrobial treatment. Campylobacter jejuni is a common finding in chickens, whereas species such as C. avium and C. helveticus were newly reported in Ethiopia, revealing a variability that needs to be monitored in light of the public health significance of this pathogen.
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14
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Lambrecht NJ, Wilson ML, Bridges D, Eisenberg JNS, Adu B, Baylin A, Folson G, Jones AD. Ruminant-Related Risk Factors are Associated with Shiga Toxin-Producing Escherichia coli Infection in Children in Southern Ghana. Am J Trop Med Hyg 2022; 106:513-522. [PMID: 34844207 PMCID: PMC8832919 DOI: 10.4269/ajtmh.21-0550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/27/2021] [Indexed: 02/03/2023] Open
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]: 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.
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Affiliation(s)
- Nathalie J. Lambrecht
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan;,Address correspondence to Nathalie J. Lambrecht, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Public Health, Charitéplatz 1, 10117 Berlin, Germany. E-mail:
| | - Mark L. Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Dave Bridges
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Joseph N. S. Eisenberg
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Ana Baylin
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan;,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Gloria Folson
- Department of Nutrition, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Andrew D. Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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15
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Chala G, Eguale T, Abunna F, Asrat D, Stringer A. Identification and Characterization of Campylobacter Species in Livestock, Humans, and Water in Livestock Owning Households of Peri-urban Addis Ababa, Ethiopia: A One Health Approach. Front Public Health 2021; 9:750551. [PMID: 34926375 PMCID: PMC8677049 DOI: 10.3389/fpubh.2021.750551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/27/2021] [Indexed: 12/22/2022] Open
Abstract
Campylobacter is the most common cause of bacterial infectious diarrhea and acute gastroenteritis globally, and is recognized as a significant zoonotic pathogen. Antimicrobial resistance amongst Campylobacter isolates is a significant global concern. A cross-sectional study was conducted to identify and characterize Campylobacter species in humans, animals and water sources in livestock owning households of peri-urban Addis Ababa, Ethiopia; and to characterize antimicrobial resistance. A total of 519 fecal samples from humans (n = 99), livestock (n = 179), poultry (n = 69), and water (n = 172) were collected. Samples were cultured for viable Campylobacter spp. and multiplex PCR utilized for the identification and confirmation. Antimicrobial susceptibility of the isolates was assessed using the Kirby-Bauer disc diffusion method. Campylobacter spp. was detected in 67/519 (13.0%) of the total tested samples, and the household level prevalence of Campylobacter was 42.4%. The prevalence of Campylobacter spp. was: humans (10.1%), cattle (18.5%), poultry (13.0%), sheep (13.3%), goats (7.1%), and water (10.5%). Campylobacter jejuni and C. fetus were the most frequently isolated species, followed by C. coli. The majority of isolates obtained from human samples had co-occurrence with isolates from cattle, poultry or water samples from the same household. The use of stored water, the practice of indoor and outdoor manure collecting, and animal species Campylobacter positivity were significantly associated with greater odds of human Campylobacter spp. positivity. All Campylobacter isolates from humans, poultry, sheep, goats and water, and 96.0% of isolates from cattle were resistant to at least one or more of the tested antimicrobials, with 95.5% of isolates resistant to three or more classes of antimicrobials. A One Health approach is recommended to further investigate Campylobacter species infections, and other zoonotic infectious diseases, in the livestock owning populations in Ethiopia, where there is close interaction between humans, animals and the environment.
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Affiliation(s)
- Gemechu Chala
- College of Veterinary Medicine, Hawassa University, Hawassa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fufa Abunna
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrew Stringer
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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16
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Chen D, Mechlowitz K, Li X, Schaefer N, Havelaar AH, McKune SL. Benefits and Risks of Smallholder Livestock Production on Child Nutrition in Low- and Middle-Income Countries. Front Nutr 2021; 8:751686. [PMID: 34778344 PMCID: PMC8579112 DOI: 10.3389/fnut.2021.751686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022] Open
Abstract
Livestock production may improve nutritional outcomes of pregnant women and children by increasing household income, availability of nutrient-dense foods, and women's empowerment. Nevertheless, the relationship is complex, and the nutritional status of children may be impaired by presence of or proximity to livestock and their pathogens. In this paper, we review the benefits and risks of livestock production on child nutrition. Evidence supports the nutritional benefits of livestock farming through income, production, and women's empowerment. Increasing animal source food consumption requires a combination of efforts, including improved animal management so that herd size is adequate to meet household income needs and consumption and addressing sociocultural and gendered norms. Evidence supports the inclusion of behavior change communication strategies into livestock production interventions to facilitate the sustainability of nutritional benefits over time, particularly interventions that engage women and foster dimensions of women's empowerment. In evaluating the risks of livestock production, evidence indicates that a broad range of enteric pathogens may chronically infect the intestines of children and, in combination with dietary deficits, may cause environmental enteric dysfunction (EED), a chronic inflammation of the gut. Some of the most important pathogens associated with EED are zoonotic in nature with livestock as their main reservoir. Very few studies have aimed to understand which livestock species contribute most to colonization with these pathogens, or how to reduce transmission. Control at the point of exposure has been investigated in a few studies, but much less effort has been spent on improving animal husbandry practices, which may have additional benefits. There is an urgent need for dedicated and long-term research to understand which livestock species contribute most to exposure of young children to zoonotic enteric pathogens, to test the potential of a wide range of intervention methods, to assess their effectiveness in randomized trials, and to assure their broad adaptation and sustainability. This review highlights the benefits and risks of livestock production on child nutrition. In addition to identifying research gaps, findings support inclusion of poor gut health as an immediate determinant of child undernutrition, expanding the established UNICEF framework which includes only inadequate diet and disease.
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Affiliation(s)
- Dehao Chen
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Karah Mechlowitz
- Department of Social and Behavioral Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Xiaolong Li
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Nancy Schaefer
- Health Science Center Libraries, University of Florida, Gainesville, FL, United States
| | - Arie H. Havelaar
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
- Institute for Sustainable Food Systems, University of Florida, Gainesville, FL, United States
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Center for African Studies, University of Florida, Gainesville, FL, United States
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17
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Budge S, Hutchings P, Parker A, Tyrrel S, Norton S, Garbutt C, Woldemedhin F, Jemal MY, Moges M, Hussen S, Beyene H. A randomised controlled feasibility trial of a BabyWASH household playspace: The CAMPI study. PLoS Negl Trop Dis 2021; 15:e0009514. [PMID: 34260591 PMCID: PMC8312948 DOI: 10.1371/journal.pntd.0009514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 07/26/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022] Open
Abstract
Background Water, sanitation and hygiene (WASH) interventions should support infant growth but trial results are inconsistent. Frequently, interventions do not consider behaviours or transmission pathways specific to age. A household playspace (HPS) is one intervention component which may block faecal-oral transmission. This study was a two-armed, parallel-group, randomised, controlled feasibility trial of a HPS in rural Ethiopia. It aimed to recommend proceeding to a definitive trial. Secondary outcomes included effects on infant health, injury prevention and women’s time. Methods November 2019−January 2020 106 households were identified and assessed for eligibility. Recruited households (N = 100) were randomised (blinded prior to the trial start) to intervention or control (both n = 50). Outcomes included recruitment, attrition, adherence, and acceptability. Data were collected at baseline, two and four weeks. Findings Recruitment met a priori criteria (≥80%). There was no loss to follow-up, and no non-use, meeting adherence criteria (both ≤10%). Further, 48.0% (95% CI 33.7−62.6; n = 24) of households appropriately used and 56.0% (41.3−70.0; n = 28) cleaned the HPS over four weeks, partly meeting adherence criteria (≥50%). For acceptability, 41.0% (31.3−51.3; n = 41) of infants were in the HPS during random visits, failing criteria (≥50%). Further, the proportion of HPS use decreased during some activities, failing criteria (no decrease in use). A modified Barrier Analysis described good acceptability and multiple secondary benefits, including on women’s time burden and infant injury prevention. Interpretation Despite failing some a priori criteria, the trial demonstrated mixed adherence and good acceptability among intervention households. A definitive trial to determine efficacy is warranted if recommended adjustments are made. Funding People In Need; Czech Development Agency. Trial registration RIDIE-ID-5de0b6938afb8. This research tested a new way to protect infants and young children from infections that are caused by pathogens in human and animal faeces. It tested the feasibility of using a household playspace to reduce infection by creating a hygienic environment for children to play-in in rural Ethiopia. The results show that the household playspace was well accepted, used regularly and cleaned well by participants in the study. The study also suggests a potential positive impact in reducing diarrhoea. Based on these results, we suggest that a larger scale trial be conducted to conclusively assess whether a household playspace can protect young children and infants from infection in rural Ethiopia or similar contexts.
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Affiliation(s)
- Sophie Budge
- Cranfield Water Science Institute, Cranfield University, Cranfield, United Kingdom
| | - Paul Hutchings
- Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - Alison Parker
- Cranfield Water Science Institute, Cranfield University, Cranfield, United Kingdom
| | - Sean Tyrrel
- Cranfield Water Science Institute, Cranfield University, Cranfield, United Kingdom
| | - Sam Norton
- Psychology Department, Institute of Psychiatry Psychology & Neuroscience, King’s College London, London, United Kingdom
| | | | | | | | - Mathewos Moges
- Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Siraj Hussen
- Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Hunachew Beyene
- Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
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El Baaboua A, El Maadoudi M, Bouyahya A, Kounnoun A, Bougtaib H, Belmehdi O, Senhaji NS, Abrini J. Prevalence and antimicrobial profiling of Campylobacter spp. isolated from meats, animal, and human feces in Northern of Morocco. Int J Food Microbiol 2021; 349:109202. [PMID: 33991875 DOI: 10.1016/j.ijfoodmicro.2021.109202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 03/26/2021] [Accepted: 04/13/2021] [Indexed: 01/20/2023]
Abstract
The present work was carried out to understand the occurrence and antimicrobial susceptibility of Campylobacter spp., in various samples in Northern of Morocco. For this purpose, a random sampling was undertaken from butcher shops, traditional markets, and slaughterhouse. First, the research of Campylobacter was performed according to the Moroccan standard NM ISO: 10272-1 (2008). Second, the isolates were identified by biochemical tests and real time PCR. After the biochemical and molecular identification of suspected colonies, a disk diffusion method was executed to determine the sensitivity of Campylobacter spp. against 18 antibiotics. The results showed a moderate prevalence of Campylobacter species (130/466) recovered mainly on the Campylobacter blood base agar, where C. coli (108/130) were more prevalent comparable to C. jejuni (22/130) in poultry and cattle meat, raw milk, cloacal and surface swabs, and stool of patient suffering from diarrhea. The findings supported also the sensitivity of multiplex qPCR to detect Campylobacter strains compared to Moroccan standard NM ISO: 10272-1 (2008). Among our isolates, C. jejuni were the most susceptible strain toward colistin, florfenicol, gentamicin, streptomycin, and erythromycin. Nonetheless, the presence of multidrug Campylobacter resistant strains was highly observed in C. jejuni isolated, particularly, from broiler chickens toward the antibiotic classes of cephalosporin, penicillin, monobactam, quinolone, fluoroquinolone, sulfamide, as well as tetracycline. This may be due to common use of these drugs in veterinary medicine and farms as growth factor, which limits the usefulness of these molecules. Hence, the study highlights the importance of resistance profile monitoring of these pathogens in Northern of Morocco, in order to develop appropriate control measures and to reduce the emergence of multidrug-resistant strains.
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Affiliation(s)
- Aicha El Baaboua
- Biology and Health Laboratory, Biotechnology and Applied Microbiology Team, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco; Regional Laboratory for Analysis and Research, National Office for Food Safety, Tangier, Morocco.
| | - Mohamed El Maadoudi
- Regional Laboratory for Analysis and Research, National Office for Food Safety, Tangier, Morocco
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, Genomic Center of Human Pathology, Mohammed V University in Rabat, Morocco.
| | - Ayoub Kounnoun
- Regional Laboratory for Analysis and Research, National Office for Food Safety, Tangier, Morocco; Laboratory of Applied Biology and Pathology, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco
| | - Hajar Bougtaib
- Regional Laboratory for Analysis and Research, National Office for Food Safety, Tangier, Morocco; Laboratory of Applied Biology and Pathology, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco
| | - Omar Belmehdi
- Biology and Health Laboratory, Biotechnology and Applied Microbiology Team, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco
| | - Nadia Skali Senhaji
- Biology and Health Laboratory, Biotechnology and Applied Microbiology Team, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco
| | - Jamal Abrini
- Biology and Health Laboratory, Biotechnology and Applied Microbiology Team, Department of Biology, Faculty of Science, Abdelmalek-Essaadi University, Tetouan, Morocco
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19
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Budge S, Parker A, Hutchings P, Garbutt C, Rosenbaum J, Tulu T, Woldemedhin F, Jemal M, Engineer B, Williams L. Multi-Sectoral Participatory Design of a BabyWASH Playspace for Rural Ethiopian Households. Am J Trop Med Hyg 2021; 104:884-897. [PMID: 33534743 PMCID: PMC7941829 DOI: 10.4269/ajtmh.20-0945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/21/2020] [Indexed: 12/21/2022] Open
Abstract
Growing evidence suggests current water, sanitation, and hygiene interventions do not improve domestic hygiene sufficiently to improve infant health, nor consider the age-specific behaviors which increase infection risk. A household playspace (HPS) is described as one critical intervention to reduce direct fecal-oral transmission within formative growth periods. This article details both the design and development (materials and methods), and testing (results) of a HPS for rural Ethiopian households. Design and testing followed a multi-sectoral, multistep participatory process. This included a focus group discussion (FGD), two user-centered and participatory design workshops in the United Kingdom and Ethiopia, discussions with local manufacturers, and a Trials by Improved Practices (TIPs) leading to a final prototype design. Testing included the FGD and TIPs study and a subsequent randomized controlled feasibility trial in Ethiopian households. This multi-sectoral, multistage development process demonstrated a HPS is an acceptable and feasible intervention in these low-income, rural subsistence Ethiopian households. A HPS may help reduce fecal-oral transmission and infection-particularly in settings where free-range domestic livestock present an increased risk. With the need to better tailor interventions to improve infant health, this article also provides a framework for future groups developing similar material inputs and highlights the value of participatory design in this field.
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Affiliation(s)
- Sophie Budge
- Cranfield Water Science Institute, Cranfield University, Cranfield, United Kingdom
| | - Alison Parker
- Cranfield Water Science Institute, Cranfield University, Cranfield, United Kingdom
| | - Paul Hutchings
- Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
| | | | - Julia Rosenbaum
- FHI360/United States Agency for International Development WASHPaLS Project, Washington, District of Columbia
| | | | | | | | | | - Leon Williams
- Centre for Competitive Creative Design, Cranfield University, Cranfield, United Kingdom
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20
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Chen D, McKune SL, Singh N, Yousuf Hassen J, Gebreyes W, Manary MJ, Bardosh K, Yang Y, Diaz N, Mohammed A, Terefe Y, Roba KT, Ketema M, Ameha N, Assefa N, Rajashekara G, Deblais L, Ghanem M, Yimer G, Havelaar AH. Campylobacter Colonization, Environmental Enteric Dysfunction, Stunting, and Associated Risk Factors Among Young Children in Rural Ethiopia: A Cross-Sectional Study From the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) Project. Front Public Health 2021; 8:615793. [PMID: 33553097 PMCID: PMC7862945 DOI: 10.3389/fpubh.2020.615793] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
Livestock farming provides a possible mechanism by which smallholder farmers can meet their household need for animal source foods (ASF), which may reduce the risk of stunting. However, direct/indirect contacts with domestic animals may increase colonization by Campylobacter spp., which has been associated with Environmental Enteric Dysfunction (EED) and stunting. A cross-sectional study involving 102 randomly selected children between 12 and 16 months of age was conducted in rural eastern Ethiopia to establish prevalence rates of Campylobacter colonization, EED, and stunting, and evaluate potential risk factors. Data were collected between September and December 2018. The prevalence of EED and stunting was 50% (95% CI: 40-60%) and 41% (95% CI: 32-51%), respectively. Among enrolled children, 56% had consumed some ASF in the previous 24 h; 47% had diarrhea and 50% had fever in the past 15 days. 54, 63, 71 or 43% of households owned at least one chicken, cow/bull, goat, or sheep; 54 (53%) households kept chickens indoors overnight and only half of these confined the animals. Sanitation was poor, with high levels of unimproved latrines and open defecation. Most households had access to an improved source of drinking water. The prevalence of Campylobacter colonization was 50% (95% CI: 41-60%) by PCR. In addition to the thermotolerant species Campylobacter jejuni, Campylobacter coli and Campylobacter upsaliensis, non-thermotolerant species related to Campylobacter hyointestinalis and Campylobacter fetus were frequently detected by Meta-total RNA sequencing (MeTRS). Current breastfeeding and ASF consumption increased the odds of Campylobacter detection by PCR, while improved drinking water supply decreased the odds of EED. No risk factors were significantly associated with stunting. Further studies are necessary to better understand reservoirs and transmission pathways of Campylobacter spp. and their potential impact on child health.
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Affiliation(s)
- Dehao Chen
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
| | - Sarah L. McKune
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- Center for African Studies, University of Florida, Gainesville, FL, United States
| | - Nitya Singh
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Jemal Yousuf Hassen
- Department of Rural Development and Agricultural Extension, Haramaya University, Dire Dawa, Ethiopia
| | - Wondwossen Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Mark J. Manary
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, United States
| | - Kevin Bardosh
- Department of Anthropology, University of Florida, Gainesville, FL, United States
| | - Yang Yang
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicholas Diaz
- Center for African Studies, University of Florida, Gainesville, FL, United States
| | | | - Yitagele Terefe
- College of Veterinary Medicine, Haramaya University, Dire Dawa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Mengistu Ketema
- School of Agricultural Economics and Agribusiness, Haramaya University, Dire Dawa, Ethiopia
| | - Negassi Ameha
- School of Animal and Range Science, Haramaya University, Dire Dawa, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Gireesh Rajashekara
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Loïc Deblais
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Mostafa Ghanem
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, United States
| | - Getnet Yimer
- Global One Health initiative, Office of International Affairs, The Ohio State University, Eastern Africa Regional Office, Addis Ababa, Ethiopia
| | - Arie H. Havelaar
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, United States
- Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
- Institute for Sustainable Food Systems, University of Florida, Gainesville, FL, United States
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