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Protocols for genomic epidemiology and source attribution of enteric bacteria causing diarrhoeal disease across Africa

  • Henry Badji
  • , Ben Pascoe
  • , Madison P. Goforth
  • , Evangelos Mourkas
  • , Evariste Bako
  • , Isidore J.O. Bonkoungou
  • , Modeste T. Gampene
  • , Marguerite Edith Malatala Nikiema
  • , Barthélemy S. Zoma
  • , Ousman E. Bah
  • , Eustacia Jane Cassell
  • , Abdoulie K. Ceesay
  • , Bubacarr E. Ceesay
  • , Ousman Ceesay
  • , Bakary Conteh
  • , Lamin Drammeh
  • , Binta Faye
  • , Abdoulie F. Jallow
  • , Fatima Jallow
  • , Ousman Jallow
  • Samba Juma Jallow, Pa Modou Joof, Modou Kandeh, Mehrab Karim, Jarra Manneh, Abdou Ceesay, Ebrima Fofana, Mamud Jallow, Modou B. Jarju, Samba Bah, Dodou Sanyang, Demba B. Jallow, Mukaila I. Alebiosu, Atanyiwoen Brusah, Akosua Bonsu Karikari, Courage K.S. Saba, Kaisa Haukka, C. Matilda (Tilly) Collins, Adrian W. Leach, Polina Levontin, Shani U.P. Ali, Frances M. Colles, Matthew David Hitchings, Martin Antonio, Abdul Karim Sesay, Ozan Gundogdu, M. Jahangir Hossain, Samuel K. Sheppard
  • London School of Hygiene & Tropical Medicine
  • Faculty of Veterinary Medicine
  • Chiang Mai University
  • University of Oxford
  • Ineos Oxford Institute for Antimicrobial Research
  • Zoonosis Science Center
  • Uppsala University
  • Universite Joseph Ki-Zerbo
  • Government of the Gambia
  • Ministry of Health
  • National Agricultural Research Institute (NARI)
  • University for Development Studies Ghana
  • University of Helsinki
  • Imperial College London
  • Swansea University

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Enteric bacterial pathogens are a major cause of diarrhoeal disease in low-income and middle-income countries, with complex transmission pathways involving human, animal and environmental reservoirs. Conventional epidemiological and microbiological approaches provide important insights into pathogen burden and distribution but lack the resolution needed to characterise fine-scale diversity, antimicrobial resistance (AMR) and transmission dynamics. Whole-genome sequencing offers high-resolution tools to investigate these processes within a One Health framework. Methods and analysis: The Genomic Epidemiology and Transmission of Campylobacter in Africa (GETCampy-Africa) study uses a multicountry, One Health design to investigate pathogen diversity, source attribution and transmission pathways. The study uses a case–control framework, recruiting children with medically attended diarrhoea and asymptomatic community controls across sites in Burkina Faso, Ghana and The Gambia. Samples were collected from human participants, domestic animals and environmental sources following standardised protocols. Participant enrolment and sample collection have been completed, while laboratory processing, sequencing and genomic analyses are ongoing. Genomic data are analysed to assess population structure, AMR profiles and probabilistic attribution of isolates to potential reservoirs using comparative genomics and machine learning approaches. Ethics and dissemination: Ethical approval was obtained from relevant national and institutional committees in all participating countries. Written informed consent was obtained from participants or their guardians prior to enrolment. Findings will be disseminated through peer-reviewed publications, stakeholder engagement activities and open-access platforms to support public health interventions and policy development.

Original languageEnglish
Article numbere109566
Number of pages13
JournalBMJ Open
Volume16
Issue number6
Early online date25 Jun 2026
DOIs
Publication statusPublished - 25 Jun 2026

Acknowledgements

We are grateful to the participants, caregivers and families who participated in this study. We also wish to thank the clinical, field, laboratory and data staff of the GETCampy-Africa study for their exceptional hard work, dedication and contribution to the project. Special thanks also go to the clinicians, administrative staff and health officials at every site who generously provided facilities and support for the conduct of the study. We are grateful to Angela Coker, Isatou Foon and Modou Gaye at MRCG at LSHTM for providing logistical support for the study. This article is dedicated to the memory of Prof John Mumford and Dr John Holt with grateful acknowledgement of their contributions to this article and their wider contribution to research.

Funding

This work was supported by the UK Research and Innovation Medical Research Council (MR/L015080/1, MR/T030062/1, MR/V001213/1, MC_UU_00031/1)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • BACTERIOLOGY
  • Community child health
  • Gastrointestinal infections
  • Protocols & guidelines

ASJC Scopus subject areas

  • General Medicine

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