Background Campylobacter species (mainly C. jejuni and C. coli) are common causes of gastroenteritis in humans, particularly under-fives in middle-income and low-income countries. We conducted a systematic review and meta-analysis of evidence on the prevalence of campylobacteriosis and its association with sociodemographic and animal exposure in under-five children (UFC) of East African countries. Methods PubMed/MEDLINE, Wiley Online Library, Research4life programmes (HINARI, AGORA, OARE, and ARDI), Cochrane Library, CINAHL, Google Scholar, and ResearchGate were searched for eligible studies published from 2009 until August 31, 2024, in countries of East Africa. Studies that didn’t present full text and prevalence data in UFC were excluded. Published articles with good quality scores using the JBI (Joanna Briggs Institute) criteria were used for data extraction. The STATA statistical software version 17 (STATACorp, 2021) was used to perform the meta-analysis using a random-effects model. The PROSPERO registration number for this systematic review and meta-analysis is CRD42024599881. Results The highest Campylobacter prevalence was reported from Ethiopia (63.8%), while the lowest was from Zambia and Madagascar (1.0%). The odds of being positive for thermophilic Campylobacter species were 1.2 in males (95% CI = 0.9 - 1.5). Subgroup analysis revealed a pooled OR (odds ratio) of 1.5 (95% CI: 0.9–2.4) in the Horn of Africa and 1.8 (95% CI: 1.2–2.8) in areas situated above 1,500 meters above sea level (m.a.s.l.) for children younger than one year compared to older counterparts. A pooled OR of 1.3 (95% CI = 0.7–2.2) was found for thermophilic Campylobacter infection among children exposed to poultry. Eighty percent of studies reported a higher prevalence of campylobacteriosis in the < 2-year age category. Moreover, 63% of studies reported a relatively higher prevalence (p > 0.05) in rural settings. The range of prevalence for thermophilic species includes 1.0–19.0% (C. jejuni), 0.4 -7.0% (C. coli), and 0.9–1.3% (C. lari), while no study reported C. upseliansis. From these, C. jejuni accounts for 64–100% of the total Campylobacter isolates. Conclusion There was a potential trend toward increased risk of thermophilic campylobacteriosis in male children. Elevation and publication year influence the occurrence of thermophilic Campylobacter in different age categories. Exposure to poultry is also a potential risk for UFC campylobacteriosis, showing the importance of practicing avoiding/limiting contact with animals.

Prevalence and determinants of Campylobacter infection in under-five children of East Africa: systematic review and meta-analysis

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2026年1月14日

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Bruk Abraha,
Nega Assefa

摘要

Background

Campylobacter species (mainly C. jejuni and C. coli) are common causes of gastroenteritis in humans, particularly under-fives in middle-income and low-income countries. We conducted a systematic review and meta-analysis of evidence on the prevalence of campylobacteriosis and its association with sociodemographic and animal exposure in under-five children (UFC) of East African countries.

Methods

PubMed/MEDLINE, Wiley Online Library, Research4life programmes (HINARI, AGORA, OARE, and ARDI), Cochrane Library, CINAHL, Google Scholar, and ResearchGate were searched for eligible studies published from 2009 until August 31, 2024, in countries of East Africa. Studies that didn’t present full text and prevalence data in UFC were excluded. Published articles with good quality scores using the JBI (Joanna Briggs Institute) criteria were used for data extraction. The STATA statistical software version 17 (STATACorp, 2021) was used to perform the meta-analysis using a random-effects model. The PROSPERO registration number for this systematic review and meta-analysis is CRD42024599881.

Results

The highest Campylobacter prevalence was reported from Ethiopia (63.8%), while the lowest was from Zambia and Madagascar (1.0%). The odds of being positive for thermophilic Campylobacter species were 1.2 in males (95% CI = 0.9 - 1.5). Subgroup analysis revealed a pooled OR (odds ratio) of 1.5 (95% CI: 0.9–2.4) in the Horn of Africa and 1.8 (95% CI: 1.2–2.8) in areas situated above 1,500 meters above sea level (m.a.s.l.) for children younger than one year compared to older counterparts. A pooled OR of 1.3 (95% CI = 0.7–2.2) was found for thermophilic Campylobacter infection among children exposed to poultry. Eighty percent of studies reported a higher prevalence of campylobacteriosis in the < 2-year age category. Moreover, 63% of studies reported a relatively higher prevalence (p > 0.05) in rural settings. The range of prevalence for thermophilic species includes 1.0–19.0% (C. jejuni), 0.4 -7.0% (C. coli), and 0.9–1.3% (C. lari), while no study reported C. upseliansis. From these, C. jejuni accounts for 64–100% of the total Campylobacter isolates.

Conclusion

There was a potential trend toward increased risk of thermophilic campylobacteriosis in male children. Elevation and publication year influence the occurrence of thermophilic Campylobacter in different age categories. Exposure to poultry is also a potential risk for UFC campylobacteriosis, showing the importance of practicing avoiding/limiting contact with animals.