Protocol for the PATHOME study: a cohort study on urban societal development and the ecology of enteric disease transmission among infants, domestic animals and the environment

Kelly Baker; Sheillah Simiyu; Phylis Busienei; Fanta Gutema; Bonphace Okoth; John Agira; Christine Amondi; Abdhalah Ziraba; Alexis Kapanka; Abisola Osinuga; Collins Ouma; Daniel Sewell; Sabin Gaire; Innocent Tumwebaze; Blessing Mberu

doi:10.1136/bmjopen-2023-076067

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Protocol for the PATHOME study: a cohort study on urban societal development and the ecology of enteric disease transmission among infants, domestic animals and the environment

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Protocol for the PATHOME study: a cohort study on urban societal development and the ecology of enteric disease transmission among infants, domestic animals and the environment

Kelly Baker, Sheillah Simiyu, Phylis Busienei, Fanta Gutema, Bonphace Okoth, John Agira, Christine Amondi, Abdhalah Ziraba, Alexis Kapanka, Abisola Osinuga, …

BMJ open, Vol.13(11), e076067

11/24/2023

DOI: 10.1136/bmjopen-2023-076067

PMCID: PMC10680014

PMID: 38000826

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Abstract

IntroductionGlobal morbidity from enteric infections and diarrhoea remains high in children in low-income and middle-income countries, despite significant investment over recent decades in health systems and water and sanitation infrastructure. Other types of societal development may be required to reduce disease burden. Ecological research on the influence of household and neighbourhood societal development on pathogen transmission dynamics between humans, animals and the environment could identify more effective strategies for preventing enteric infections.Methods and analysisThe ‘enteric pathome’—that is, the communities of viral, bacterial and parasitic pathogens transmitted from human and animal faeces through the environment is taxonomically complex in high burden settings. This integrated cohort-exposure assessment study leverages natural socioeconomic spectrums of development to study how pathome complexity is influenced by household and neighbourhood infrastructure and hygiene conditions. We are enrolling under 12-month-old children in low-income and middle-income neighbourhoods of two Kenyan cities (Nairobi and Kisumu) into a ‘short-cohort’ study involving repeat testing of child faeces for enteric pathogens. A mid-study exposure assessment documenting infrastructural, behavioural, spatial, climate, environmental and zoonotic factors characterises pathogen exposure pathways in household and neighbourhood settings. These data will be used to inform and validate statistical and agent-based models (ABM) that identify individual or combined intervention strategies for reducing multipathogen transmission between humans, animals and environment in urban Kenya.Ethics and disseminationThe protocols for human subjects’ research were approved by Institutional Review Boards at the University of Iowa (ID-202004606) and AMREF Health Africa (ID-ESRC P887/2020), and a national permit was obtained from the Kenya National Commission for Science Technology and Innovation (ID# P/21/8441). The study was registered on Clinicaltrials.gov (Identifier: NCT05322655) and is in pre-results stage. Protocols for research on animals were approved by the University of Iowa Animal Care and Use Committee (ID 0042302).

Children & Youth

Disease Control

Disease Prevention

Ecology

Infrastructure

Vaccines

Water Supply

Animals

Cholera

Diarrhea

Drinking water

Epidemics

Fatalities

Fever

Households

Hygiene

Low income groups

Middle class

Mortality

Neighborhoods

Pathogens

Population

Sanitation

Sewer systems

Tropical diseases

Details

Title: Subtitle: Protocol for the PATHOME study: a cohort study on urban societal development and the ecology of enteric disease transmission among infants, domestic animals and the environment
Creators: Kelly Baker - University of Iowa
Sheillah Simiyu - African Population and Health Research Center
Phylis Busienei - African Population and Health Research Center
Fanta Gutema - University of Iowa
Bonphace Okoth - African Population and Health Research Center
John Agira - African Population and Health Research Center
Christine Amondi - African Population and Health Research Center
Abdhalah Ziraba - African Population and Health Research Center
Alexis Kapanka - University of Iowa
Abisola Osinuga - University of Iowa
Collins Ouma - Maseno University
Daniel Sewell - University of Iowa
Sabin Gaire - University of Iowa
Innocent Tumwebaze - African Population and Health Research Center
Blessing Mberu - African Population and Health Research Center
Resource Type: Journal article
Publication Details: BMJ open, Vol.13(11), e076067
DOI: 10.1136/bmjopen-2023-076067
PMID: 38000826
PMCID: PMC10680014
NLM abbreviation: BMJ Open
eISSN: 2044-6055
Publisher: BMJ Publishing Group LTD
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: 01TW011795
Language: English
Date published: 11/24/2023
Academic Unit: Occupational and Environmental Health; Epidemiology; Biostatistics; Public Policy Center (Archive)
Record Identifier: 9984521460102771

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