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      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

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          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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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                21 January 2021
                2020
                : 8
                : 615793
                Affiliations
                [1] 1Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida , Gainesville, FL, United States
                [2] 2Emerging Pathogens Institute, University of Florida , Gainesville, FL, United States
                [3] 3Center for African Studies, University of Florida , Gainesville, FL, United States
                [4] 4Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida , Gainesville, FL, United States
                [5] 5Department of Rural Development and Agricultural Extension, Haramaya University , Dire Dawa, Ethiopia
                [6] 6Department of Veterinary Preventive Medicine, The Ohio State University , Columbus, OH, United States
                [7] 7Department of Pediatrics, Washington University in St. Louis , St. Louis, MO, United States
                [8] 8Department of Anthropology, University of Florida , Gainesville, FL, United States
                [9] 9Department of Biostatistics, College of Public Health and Health Professions & College of Medicine, University of Florida , Gainesville, FL, United States
                [10] 10Office of Research Affairs, Haramaya University , Dire Dawa, Ethiopia
                [11] 11College of Veterinary Medicine, Haramaya University , Dire Dawa, Ethiopia
                [12] 12College of Health and Medical Sciences, Haramaya University , Dire Dawa, Ethiopia
                [13] 13School of Agricultural Economics and Agribusiness, Haramaya University , Dire Dawa, Ethiopia
                [14] 14School of Animal and Range Science, Haramaya University , Dire Dawa, Ethiopia
                [15] 15Global One Health initiative, Office of International Affairs, The Ohio State University, Eastern Africa Regional Office , Addis Ababa, Ethiopia
                [16] 16Institute for Sustainable Food Systems, University of Florida , Gainesville, FL, United States
                Author notes

                Edited by: Thandavarayan Ramamurthy, National Institute of Cholera and Enteric Diseases (ICMR), India

                Reviewed by: Alison Parker, Cranfield University, United Kingdom; Sucharit Basu Neogi, International Centre for Diarrhoeal Disease Research (ICDDR), Bangladesh

                *Correspondence: Arie H. Havelaar ariehavelaar@ 123456ufl.edu

                This article was submitted to Environmental health and Exposome, a section of the journal Frontiers in Public Health

                ‡Present address: Mostafa Ghanem, Department of Veterinary Medicine, University of Maryland, College Park, MD, United States

                †These authors have contributed equally to this work

                Article
                10.3389/fpubh.2020.615793
                7862945
                33553097
                0ac155b1-5e53-4866-acdd-560e7b6b4b02
                Copyright © 2021 Chen, McKune, Singh, Yousuf Hassen, Gebreyes, Manary, Bardosh, Yang, Diaz, Mohammed, Terefe, Roba, Ketema, Ameha, Assefa, Rajashekara, Deblais, Ghanem, Yimer and Havelaar.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 09 October 2020
                : 17 December 2020
                Page count
                Figures: 2, Tables: 6, Equations: 0, References: 60, Pages: 13, Words: 10283
                Categories
                Public Health
                Original Research

                campylobacter,environmental enteric dysfunction,undernutrition,cross-sectional study,ethiopia,smallholder farming

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