Acquisition and clearance dynamics of Campylobacter spp. in children in low- and middle-income countries

Dehao Chen; Arie H Havelaar; James A Platts-Mills; Yang Yang

doi:10.1016/j.epidem.2024.100749

Acquisition and clearance dynamics of Campylobacter spp. in children in low- and middle-income countries

Epidemics. 2024 Mar:46:100749. doi: 10.1016/j.epidem.2024.100749. Epub 2024 Feb 10.

Authors

Dehao Chen¹, Arie H Havelaar², James A Platts-Mills³, Yang Yang⁴

Affiliations

¹ Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; Department of Epidemiology, Emory University, Atlanta, GA, USA.
² Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, USA; Global Food Systems Institute, University of Florida, Gainesville, FL, USA.
³ Division of Infectious Diseases and International Health, University of Virginia Health System, Charlottesville, VA, USA.
⁴ Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA. Electronic address: yang.yang4@uga.edu.

Abstract

The prevalence of Campylobacter infection is generally high among children in low- and middle-income countries (LMIC), but the dynamics of its acquisition and clearance are understudied. We aim to quantify this process among children under two years old in eight LMIC using a statistical modeling approach, leveraging enzyme-immunoassay-based Campylobacter genus data and quantitative-PCR-based Campylobacter jejuni/coli data from the MAL-ED study. We developed a Markov model to compare the dynamics of acquisition and clearance of Campylobacter across countries and to explore the effect of antibiotic usage on Campylobacter clearance. Clearance rates were generally higher than acquisition rates, but their magnitude and temporal pattern varied across countries. For C. jejuni/coli, clearance was faster than acquisition throughout the two years at all sites. For Campylobacter spp., the acquisition rate either exceeded or stayed very close to the clearance rate after the first half year in Bangladesh, Pakistan and Tanzania, leading to high prevalence. Bangladesh had the shortest (28 and 57 days) while Brazil had the longest (328 and 306 days) mean times from last clearance to acquisition for Campylobacter spp. and C. jejuni/coli, respectively. South Africa had the shortest (10 and 8 days) while Tanzania had the longest (53 and 41 days) mean times to clearance for Campylobacter spp. and C. jejuni/col, respectively. The use of Macrolide accelerated clearance of C. jejuni/coli in Bangladesh and Peru and of Campylobacter spp. in Bangladesh and Pakistan. Fluoroquinolone showed statistically meaningful effects only in Bangladesh but for both Campylobacter groups. Higher prevalence of Campylobacter infection was mainly driven by a high acquisition rate that was close to or surpassing the clearance rate. Acquisition rate usually peaked in 11-17 months of age, indicating the importance of targeting the first year of life for effective interventions to reduce exposures.

Keywords: Acquisition; Antibiotic effect; Campylobacter; Clearance; Markov model.

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Campylobacter Infections* / drug therapy
Campylobacter Infections* / epidemiology
Campylobacter jejuni*
Campylobacter*
Child
Developing Countries
Humans
Infant

Substances

Anti-Bacterial Agents

Grants and funding

R01 AI153254/AI/NIAID NIH HHS/United States