INBUGS-NG Cohort Design

A parallel comparison with the Pakistan cohort INBUGS-P is planned to distinguish setting-specific features from shared patterns in early-life microbiome development. INBUGS-NG is described as one of the first prospective longitudinal African infant cohorts to combine infant, maternal, breast milk, and environmental sampling with long-read shotgun metagenomics. Of 90 enrolled dyads, 87 had baseline biological samples, and 79 remained in active follow-up by day 90, representing 91% retention. The small sample size limits statistical power for stratified analyses of subgroups such as caesarean deliveries, exclusively breastfed infants, and antibiotic-exposed infants. The study was embedded as a substudy of BARNARDS-II, which investigates neonatal sepsis and antibiotic resistance across multiple low- and middle-income countries. INBUGS-NG is a prospective longitudinal cohort following mother-infant dyads from birth through 12 months in northern Nigeria. The study collected infant stool at 10 scheduled time points during the first year, with additional intensified sampling after infant antibiotic exposure.