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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.
Highlights
Undernutrition has been identified as an underlying cause in 45% of under-five mortality globally [1]
The metagenomic results confirmed that the thermotolerant C. jejuni and C. coli, which are commonly associated with chickens and livestock, are frequently colonizing at high abundance levels in the gut of young children, that we have presented in more details [18]
Our study reveals high burdens of Campylobacter colonization, EED, and stunting in the traditional rural Ethiopian settings of smallholder farmers
Summary
Undernutrition has been identified as an underlying cause in 45% of under-five mortality globally [1]. In Africa, an average of 31.2% of children under-five are stunted, which indicates chronic undernutrition and is represented by length/height for age Z-scores (LAZ/HAZ) of −2 or more standard deviations below median length/height for age of a reference population. Stunted children are short in stature for their age, at increased risk of infectious diseases and vaccine failures, have poor cognitive development, resulting in increased morbidity and mortality and lower lifetime productivity, and income [2,3,4,5]. In Ethiopia, rates of stunting among children under-five are alarmingly high—up to 38% based on a 2018 report [6]. A recent study indicates that average LAZ in a large sample (N = 1,750) of Ethiopian children decreased from −0.7 to −2.0 between 6 and 18 months of age [7]. Linear growth faltering during this time period in a child’s life significantly contributes to the stunting events and to the overall health status later in life
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