Peer-reviewed article
Early life exposures of enteric pathogens and nutritional outcomes in Timor-Leste: a longitudinal birth cohort study protocol
Haribondhu Sarma, Salvador Amaral, M Lay, Lesy Careca Atok, Tessa Oakley et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This is the protocol for a birth cohort study in three municipalities of Timor-Leste (Dili, Ermera and Ainaro). It will follow 450 infants from birth to 24 months to see how early exposure to disease-causing germs in the gut relates to child growth. Researchers will test stool, food, water, soil and animal samples, measure children's growth, and use surveys and interviews on feeding and food safety. The study runs from November 2024 to October 2027. No results are reported yet.
Key points
- Timor-Leste has one of the highest childhood stunting rates in the world, estimated at 47% of children under 5.
- 450 infants will be recruited at birth and followed for 24 months.
- Home visits are every 3 months in year 1 and every 6 months in year 2.
- Faecal, food, water, soil and domestic animal samples will be tested for bacterial, viral and parasitic pathogens.
- Findings will be shared through publications, community workshops and policy briefs in English and Tetum.
Limitations
This is a study protocol, so it contains no findings on how enteric infection relates to child growth. It also does not evaluate an intervention.
Abstract
Introduction Child undernutrition remains a major public health problem in low- and middle-income countries. Timor-Leste has one of the highest childhood stunting rates worldwide, affecting an estimated 47% of children under 5 years. Repeated exposure to enteric pathogens is increasingly recognised as a contributor to malnutrition, yet the interplay between enteric infection, environmental exposure and socioeconomic factors remains poorly understood in this setting. This protocol describes a longitudinal birth cohort study, conducted within a One Health framework, examining early-life enteric pathogen exposure and its relationship with nutritional outcomes in Timor-Leste. Methods and analysis This mixed-methods longitudinal birth cohort study, part of the Bacteria, Enteropathy and Nutrition research programme, is being conducted in three municipalities of Timor-Leste (Dili, Ermera and Ainaro) from November 2024 to October 2027. We will recruit 450 infants at birth and follow them for 24 months, with home visits at 3 monthly intervals in year 1 and 6 monthly intervals in year 2. Faecal, food, water, soil and domestic animal samples will be tested for bacterial, viral and parasitic pathogens; child growth will be assessed using anthropometry. Structured surveys, household observations and in-depth interviews will capture food safety practices, feeding behaviours and socioeconomic factors. Associations between enteric infection and child growth will be assessed using multivariable regression and longitudinal mixed-effects models; qualitative data will be analysed thematically. Ethics and dissemination Ethical approval has been granted by the Human Research Ethics Committee and Veterinary Research Ethics Committee of the Ministry of Health, Timor-Leste (1827/INSP-TL/UEPD-AL/X/2024), Menzies School of Health Research (EC00153) and the Australian National University (H/2024/0964). Written informed consent will be obtained from parents or guardians. Findings will be disseminated through peer-reviewed publications, conference presentations, community workshops and policy briefs in English and Tetum.