Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis

Background: Backyard poultry-raising is common in rural Bangladeshi households. Raising poultry contributes to fecal contamination of the domestic environment, increasing children’s exposure to enteric pathogens, including Campylobacter, which has been associated with child stunting. Objective: To investigate the effectiveness of a behavior change communication and counseling intervention to encourage households to confine poultry outside of the household dwelling in a shed at night and improve poultry feces management. Methods: We conducted a two-arm pre-post pilot study. Households in both arms received the behavior change communication and counseling intervention. Households in the subsidy arm also received ~23 USD for the construction of a poultry shed for nighttime housing. We administered a household survey and spot-check before and after intervention implementation among 37 subsidy and 42 non-subsidy households. Results: At endline, 58% of all households had a poultry shed (87% of subsidy and 33% of non-subsidy households) and the percentage of households confining all poultry outside the house the previous night was significantly higher at endline (33%) compared to baseline (2.5%) (prevalence difference [PD]: 30 percentage points [pp]; 95% CI: [19, 41]). Additionally, more households had no visible poultry feces piles inside the house compared to baseline (PD: 26pp 95% CI: [12, 41]), but there were no significant differences in the number of poultry feces piles in the courtyard or veranda. Discussion: Our intervention effectively encouraged households to confine poultry outside of household dwellings at night and to maintain an indoor living space free of poultry feces. Households were willing and able to construct a shed even without a subsidy. Households that received a subsidy were more likely to construct a shed. Future studies should assess if housing all poultry outside the household dwelling reduces children’s exposure to poultry feces enough to mitigate health risks associated with poultry ownership.

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Pathogens and Antimicrobial Resistance Genes in Household Environments: A Study of Soil Floors and Cow Dung in Rural Bangladesh

Nguyen,

Ratnasiri,

Heitmann

et al. 2024

Preprint

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In low- and middle-income countries, living in homes with soil floors and animal cohabitation may expose children to fecal organisms, increasing risk of enteric and antimicrobial-resistant infections. Our objective was to understand whether cow cohabitation in homes with soil floors in rural Bangladesh contributed to the presence and diversity of potential pathogens and antimicrobial resistance genes (ARGs) in the home. In 10 randomly selected households in rural Sirajganj District, we sampled floor soil and cow dung, which is commonly used as sealant in soil floors. We extracted DNA and performed shotgun metagenomic sequencing to explore potential pathogens and ARGs in each sample type. We detected 6 potential pathogens in soil only, 49 pathogens in cow dung only, and 167 pathogens in both soil and cow dung. Pathogen species with relative abundances >5% in both soil floors and cow dung from the same households includedE. coli(N=8 households),Salmonella enterica(N=6),Klebsiella pneumoniae(N=2), andPseudomonas aeruginosa(N=1). Cow dung exhibited modestly higher pathogen genus richness compared to soil floors (Wilcoxon signed-rank test p=0.002). Using Bray-Curtis dissimilarity, pathogen species community composition differed between floors and cow dung (PERMANOVA p<0.001). All soil floors and cow dung samples contained ARGs against antibiotic classes including sulfonamides, rifamycin, aminoglycosides, lincosamides, and tetracycline. Paired floor and cow dung samples shared ARGs against rifamycin. Our findings support the development of interventions to reduce soil and animal feces exposure in rural, low-income settings.

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Is detection of enteropathogens and human or animal faecal markers in the environment associated with subsequent child enteric infections and growth: an individual participant data meta-analysis

Cited by 4 publications

References 47 publications

Breaking the infection pathway for childhood diarrhoea

Breaking the infection pathway for childhood diarrhoea

A pilot pre-post trial with and without subsidy to promote safe backyard poultry-raising practices to prevent exposure to poultry and poultry feces in rural Bangladesh

Pathogens and Antimicrobial Resistance Genes in Household Environments: A Study of Soil Floors and Cow Dung in Rural Bangladesh

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