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AN INTERVENTION-CONTROL STUDY OF CORRALLING OF FREE-RANGING CHICKENS TO CONTROL CAMPYLOBACTER INFECTIONS AMONG CHILDREN IN A PERUVIAN PERIURBAN SHANTYTOWN

RICHARD A. OBERHELMAN Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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ROBERT H. GILMAN Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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PATRICIA SHEEN Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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JULIANNA CORDOVA Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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MIRKO ZIMIC Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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LILIA CABRERA Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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RINA MEZA Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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JUAN PEREZ Asociación Benéfica PRISMA, Lima. Peru; Department of International Health, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland; U. S. Naval Medical Research Center Detachment, Lima. Peru; Department of Tropical Medicine, Tulane School of Public Health, New Orleans, Louisiana; Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru

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Campylobacter jejuni is a major cause of diarrhea among children in developing countries. Since free-ranging chickens are a major source of Campylobacter infections, we hypothesized that corralling of these chickens would result in decreased rates of Campylobacter infections and Campylobacter-related diarrhea. We tested this hypothesis in Peruvian families in a periruban shantytown with free-ranging chickens and randomized by household using a (corralling) intervention versus control study design. Samples from participants and chickens were cultured for Campylobacter at the start of surveillance, and samples from children less than six years of age with diarrhea episodes and two sentinel chickens were cultured for Campylobacter monthly. Overall, 4,257 human stool specimens and 3,950 avian stool specimens were cultured over a 17-month period. Rates of Campylobacter-related diarrhea in children were significantly higher in the corral group, which demonstrated twice the incidence of Campylobacter diarrhea compared with controls overall, and seven times the rate of Campylobacter diarrhea versus controls in the subset with more than 20 household chickens. Rates of asymptomatic infection with Campylobacter were similar. Although corralling may be useful if corrals are distant from living quarters, it is not advisable as a control measure for Campylobacter in communities such as this.

Author Notes

  • 1

    Oberhelman RA, Taylor D, 1999. Campylobacter infections in developing countries. Blaser MJ, Nachamkin I, eds. Campylobacter. Washington, DC: American Society for Microbiology Press, 139–154.

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  • 2

    Oberhelman RA, Gilman RH, Taylor DN, Black RE, Sheen P, Cabrera L, Madico G, Lescano AG, 1999. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in Peruvian children. J Pediatr 134 :15–20.

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  • 3

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  • 4

    Guerrant RL, Hughes J, Lima N, Crane J, 1990. Diarrhea in developed and developing countries: magnitude, special settings, and etiologies. Rev Infect Dis 12 :S41–S50.

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  • 5

    Skirrow MB, Blaser MJ, 1995. Campylobacter jejuni. Blaser M, Smith PD, Ravdin JI, Greenberg HB, Guerrant RL, eds. Infections of the Gastrointestinal Tract. First edition. New York: Raven Press, 825–848.

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  • 6

    Grados O, Bravo N, Black RE, Butzler JP, 1988. Paediatric Campylobacter diarrhea from household exposure to live chickens in Lima, Peru. Bull World Health Organ 66 :369–374.

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  • 7

    Marquis GS, Ventura G, Gilman RH, Porras E, Miranda E, Carbajal L, Pentafiel M, 1990. Fecal contamination of shantytown toddlers in households with non-corralled poultry, Lima, Peru. Am J Public Health 80 :146–149.

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  • 8

    Harvey SA, Winch PJ, Leontsini E, Torres Gayoso C, López Romero S, Gilman RM, Oberhelman RA, 2003. Domestic poultry raising practices in a Peruvian shantytown: implications for control of Campylobacter jejuni-associated diarrhea. Acta Trop 86 :41–54.

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  • 9

    Oberhelman RA, Gilman RH, Sheen P, Cordova J, Taylor DN, Zimic M, Meza R, Perez J, LeBron C, Cabrera L, Rodgers FG, Woodward DL, Price LJ, 2003. Campylobacter transmission in a Peruvian periurban shantytown: a longitudinal study of Campylobacter isolates from chickens and human in household clusters using molecular and serological strain typing techniques. J Infect Dis 187 :260–269.

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  • 10

    Zeger SL, Liang K-Y, Albert PS, 1988. Models for longitudinal data: a generalized estimating equation approach. Biometrics 44 :1049–1060.

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