Risk factors associated with Campylobacter detected by PCR in humans and animals in rural Cambodia

Campylobacter are worldwide-occurring zoonotic bacteria, with the species Campylobacter jejuni and C. coli commonly associated with diarrhoea in children in low-income countries. In this cross-sectional study, the prevalence of C. jejuni and C. coli in human and livestock faecal samples was detected by PCR and zoonotic risk factors associated with human Campylobacter positivity were identified. In total 681 humans and 753 livestock (chickens, ducks, pigs, cattle) from 269 households were sampled. Children aged <16 years were more frequently Campylobacter positive (19%) than adults (8%) and multilevel logistic models revealed that human C. jejuni positivity was associated with the following household practices: home-slaughtering [odds ratio (OR) 2·4, P = 0·01], allowing animals access to sleeping and food preparation areas (OR 2·8, P = 0·02), and eating undercooked meat (OR 6·6, P = 0·05), while frequent consumption of beef was protective (OR 0·9, P = 0·05). Associations were stronger for home-slaughtering (OR 4·9, P = 0·004) with C. jejuni infection in children only. Campylobacter was highly prevalent in pigs (72%) and chickens (56%) and risk factors associated with human Campylobacter positivity were identified throughout the meat production chain. The findings underline the importance of studying source attributions throughout the production chain and the need for upgraded understanding of Campylobacter epidemiology in low-income countries.