Ruminant-Related Risk Factors are Associated with Shiga Toxin–Producing Escherichia coli Infection in Children in Southern Ghana

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  • 1 Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan;
  • | 2 Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;
  • | 3 Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana;
  • | 4 Department of Nutrition, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana

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 {CI}]: 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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Author Notes

Address correspondence to Nathalie J. Lambrecht, Institute of Public Health, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. E-mail: nathalie.lambrecht@charite.de

Financial support: This research was supported in part by the University of Michigan International Institute, the University of Michigan African Studies Center, the University of Michigan Office of Global Public Health, the University of Michigan Rackham Graduate School, and The Dow Chemical Company Foundation through the Dow Sustainability Fellows Program at the University of Michigan.

Disclaimer: The authors declare no conflict of interest. These findings were first presented in NL’s doctoral dissertation and are included in the University of Michigan Deep Blue Repository.

Authors’ addresses: Nathalie J. Lambrecht, Institute of Public Health, Charité–Universitätsmedizin Berlin, Germany, E-mail: nathalie.lambrecht@charite.de. Mark L. Wilson and Joseph N. S. Eisenberg, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, E-mails: wilsonml@umich.edu and jnse@umich.edu. Dave Bridges, Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, E-mail: davebrid@umich.edu. Bright Adu, Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana, E-mail: badu@noguchi.ug.edu.gh. Ana Baylin, Department of Nutritional Sciences, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, E-mail: abaylin@umich.edu. Gloria Folson, Department of Nutrition, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana, E-mail: gfolson@noguchi.ug.edu.gh. Andrew D. Jones, Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, E-mail: jonesand@umich.edu.

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