Date of Award

12-14-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Najeeha Talat Iqbal

Second Advisor

Dr. Waqasuddin Khan

Third Advisor

Mr. Yasir Shafiq

Department

Community Health Sciences

Abstract

Background: One of the main members of the healthy infant gut microbiota is Bifidobacteria infantis. B. infantis is unique due to its specific ability to breakdown human milk oligosaccharides (HMO). Several factors impact B. infantis colonization in the infant gut, such as mode of delivery, feeding practices, antibiotic use, malnutrition and inflammation. Azithromycin (AZ) is a macrolide antibiotic that has been prescribed by the World Health Organization (WHO) for mass drug administration (MDA) in low to middle income countries (LMICs) for the treatment of infections and infection-related morbidity and mortality. MDA-AZ has been shown to improve child survival and may have a role in improving infant growth outcomes.
Objectives: The objectives of this study were to assess the impact of one dose of AZ on B. infantis colonization in the infant gut, and on the number of enteropathogens in the infant. We assessed these associations in the presence of several covariates that may influence B. infantis colonization.
Methods: Data from the Mumta study was used for this analysis. The Mumta study was a randomized controlled trial of lactating women (LW) and their infants.
Results: The main finding of this study was that one dose of AZ was associated with a 1.7-fold increase in colonization by B. infantis. One dose of AZ at day 42 of infant’s birth did not impact enteropathogen count. B. infantis colonization was associated with a moderate increase in the concentration of Myeloperoxidase (MPO). There is an inverse relationship between B. infantis and B. longum colonization. The expected enteropathogen count was 1.8 times higher in infants colonized with B. Infantis as compared to infants who were not. Place and Mode of delivery, maternal age and anthropometric measures were not found to be associated with B. Infantis colonization at day 56 post birth.
Conclusion: To our knowledge this is the first epidemiological study to report an association between AZ and B. Infantis colonization. It is important to understand the factors associated with B. Infantis colonization as these may represent possible targets for intervention in infant health. It is also critical to understand the role of Azithromycin in child survival and growth promotion.

First Page

1

Last Page

187

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