Benefits and Risks of Smallholder Livestock Production on Child Nutrition in Low- and Middle-Income Countries

Abstract

Livestock production may improve nutritional outcomes of pregnant women and children by increasing household income, availability of nutrient-dense foods, and women's empowerment. Nevertheless, the relationship is complex, and the nutritional status of children may be impaired by presence of or proximity to livestock and their pathogens. In this paper, we review the benefits and risks of livestock production on child nutrition. Evidence supports the nutritional benefits of livestock farming through income, production, and women's empowerment. Increasing animal source food consumption requires a combination of efforts, including improved animal management so that herd size is adequate to meet household income needs and consumption and addressing sociocultural and gendered norms. Evidence supports the inclusion of behavior change communication strategies into livestock production interventions to facilitate the sustainability of nutritional benefits over time, particularly interventions that engage women and foster dimensions of women's empowerment. In evaluating the risks of livestock production, evidence indicates that a broad range of enteric pathogens may chronically infect the intestines of children and, in combination with dietary deficits, may cause environmental enteric dysfunction (EED), a chronic inflammation of the gut. Some of the most important pathogens associated with EED are zoonotic in nature with livestock as their main reservoir. Very few studies have aimed to understand which livestock species contribute most to colonization with these pathogens, or how to reduce transmission. Control at the point of exposure has been investigated in a few studies, but much less effort has been spent on improving animal husbandry practices, which may have additional benefits. There is an urgent need for dedicated and long-term research to understand which livestock species contribute most to exposure of young children to zoonotic enteric pathogens, to test the potential of a wide range of intervention methods, to assess their effectiveness in randomized trials, and to assure their broad adaptation and sustainability. This review highlights the benefits and risks of livestock production on child nutrition. In addition to identifying research gaps, findings support inclusion of poor gut health as an immediate determinant of child undernutrition, expanding the established UNICEF framework which includes only inadequate diet and disease.

Unravelling the reservoirs for colonisation of infants with Campylobacter spp. in rural Ethiopia: protocol for a longitudinal study during a global pandemic and political tensions

“… 12 With the realisation that global child undernutrition cannot be solely attributed to deficient diets and diarrhoea, researchers have hypothesised that EED may be the key mediator between environmental exposures to enteric pathogens and undernutrition, calling for expansion of the long-established UNICEF framework of child undernutrition to incorporate poor gut health as an immediate cause of undernutrition. 13–15 …”

“…Mainly, asymptomatic infections of children with Campylobacter spp were found to be associated with EED outcomes of epithelial damage, inflammation and increased permeability of the gut, as well as growth faltering and reduced weight gain. 13 A study in Peru found that asymptomatic infection of Campylobacter had a stronger effect size on slowing weight gain than its symptomatic counterpart. 18 In the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health (MAL-ED) study, Campylobacter spp in child stools detected by Enzyme-Linked Immuno Assay (ELISA, identifying all species in the genus) had a nearly twofold higher effect on growth faltering than the thermotolerant species C. jejuni / C. coli detected by molecular methods, underscoring the potentially important role of non-thermotolerant Campylobacter spp.…”

“…12 With the realisation that global child undernutrition cannot be solely attributed to deficient diets and diarrhoea, researchers have hypothesised that EED may be the key mediator between environmental exposures to enteric pathogens and undernutrition, calling for expansion of the long-established UNICEF framework of child undernutrition to incorporate poor gut health as an immediate cause of undernutrition. [13][14][15] In recent years, two randomised controlled trials found no significant effect of traditional WaSH interventions on stunting. 16 Researchers subsequently called for 'transformative WaSH' to eradicate household faecal contamination.…”

“…The infection of enteric pathogens in CU5 is not only associated with symptomatic illness (eg, diarrhoea); importantly, asymptomatic enteric infection may lead to environmental enteric dysfunction (EED) 12. With the realisation that global child undernutrition cannot be solely attributed to deficient diets and diarrhoea, researchers have hypothesised that EED may be the key mediator between environmental exposures to enteric pathogens and undernutrition, calling for expansion of the long-established UNICEF framework of child undernutrition to incorporate poor gut health as an immediate cause of undernutrition 13–15…”

Cryptosporidium and Giardia in Livestock in Tigray, Northern Ethiopia and Associated Risk Factors for Infection: A Cross-Sectional Study

“…Furthermore, livestock manure is used for fertiliser, as fuel for cooking, and for building materials, which are typically prepared by hand by women and children (4). However, this close association between people and their animals also provides the interface for the transmission of zoonotic pathogens (5).…”