Despite delays, newborn babies in Ethiopia are now being enrolled in a research study designed to reveal their vulnerability to bacterial infections from livestock. The project’s field work planned for April 2020 had been delayed by the COVID-19 pandemic and unrest in parts of the country. Fortunately, work for the project CAGED (CAmpylobacter Genomics and Environmental Enteric Dysfunction) longitudinal study started on December 15, 2020 in Haramaya woreda (district) in eastern Ethiopia, and data collection continues until mid-2022.

Community Engagement

Previously, the team at Haramaya University has actively engaged with the community and found a great level of trust, not in the least by the active role that the university has played in COVID-19 preparedness and control. The laboratory that was built for the CAGED and EXCAM projects has served as a laboratory for COVID-19 testing for eastern Ethiopia and was certified for this purpose by the Ethiopian Public Health Institute.

Community mobilization and community advisory board selection was conducted from the 13^th to 30^th of November 2020. As a result, 63 people were selected, representing the elderly, youth and political leaders of all 12 kebeles (neighborhoods) where the project is planning to implement research activities.

The advisory board first met at Haramaya University campus on the 12^th of December 2020. The 59 advisory board members and six representatives from the government partners have participated in the orientation session. The project manager, Abdulmuen Mohammed, is the primary point of contact for the entire board. He also coordinates all project activities.

A Focus on Babies

Newborn babies are identified every week by a team in the Haramaya woreda, led by Kedir Teji. The infants will be visited monthly during their first year of life. Each month, fecal samples of the infants will be collected and tested for presence of Campylobacter species by a quantitative PCR method, similar to the test used to detect COVID-19 infections. Twice during the study period, extensive sampling will be done. This includes fecal samples of the mother, the youngest sibling, livestock (chickens, cattle, goats, and sheep), and samples of drinking water and soil inside and outside the home. All samples will be tested for thermotolerant and non-thermotolerant Campylobacter species by PCR and culture methods.

At every visit, data on the socio-economic context of the participating families will be collected. Extensive questionnaires have been developed and will be administered twice during the study period. Shorter questionnaires will be presented in all other months. The field team is comprised of three data collectors, focusing on human health (Ibsa Abdusemad), socioeconomics (Ibsa Aliyi) and animals and environment (Jafer Kedir). With the active support of the board, 39 newborn babies have been enrolled in the study in the first weeks through consent of both their parents. The goal is to ultimately include 120 babies in the study by the end of April 2021.

Developing a Foodborne Pathogens Lab Abroad

In partnership with Haramaya University, a biosafety level two lab has been built and equipped for the CAGED & EXCAM projects. This level of biosafety is needed to safely handle the fecal samples collected in the study. The scientists have a keen interest in detection of foodborne pathogens. The lab is composed of microbiology and molecular sections equipped with new equipment such as biological safety cabinets, the latest version of qPCR machines; freezers (-80^OC and -20^OC), incubators, water baths, and nanodrop spectrophotometer. The lab will be used to perform microbiological and molecular methods for the detection and speciation of Campylobacter bacteria. The lab setup is provided with continuous flow of water from a large volume water reservoir and a standby generator.

The lab team is comprised of six graduate students from Haramaya University, with four males: Bahar Mummed, Yitagele Terefe, Kedir Abdi, and Balisa Usmael; and two females: Yenenesh Demisie and Sada Muktar, who are highly motivated and passionate about the field of microbiology and molecular diagnostics. Lab activities are overseen and supported by Amanda Ojeda from the University of Florida and Loïc Deblais from The Ohio State University, who will visit the lab on a rotating basis.

Local Connections

The strong relationships of Haramaya University with the local population has been a key factor in deciding to resume the study activities. It is also an important asset to the study that all study team members were born and raised in the region and are part of the communities. As in other parts of the world, COVID-19 infections are still spreading in the eastern Ethiopia. To protect the team from becoming infected during their activities and to prevent the team from spreading the infection to the study sites, a detailed COVID-19 protocol has been implemented, building on national guidelines in Ethiopia, guidelines from Haramaya University and the Screen, Test and Protect protocol developed by the University of Florida. As experience builds up, the protocol will be further developed to address any concerns that arise during the execution of the project.

Data collection for this project will continue for more than one year. Initial results may become available in 2022, and later they will be published in scientific journals.

All study team members were born and raised in the region and are part of the communities.

2