Abstract
ABSTRACTAnimal husbandry and capture (AHC) may mitigate anemia among women and children by supplying a source of micronutrient-rich animal source foods (ASF), yet may concurrently increase exposure to anemia-inducing pathogens such as Plasmodium spp., helminths, and enteropathogens. We conducted a systematic literature review to assess the relation between AHC and anemia among women of reproductive age, school-aged children, and children aged <5 y in low- and middle-income countries (LMICs). We used a 2-stage screening process, in which 1 reviewer searched 4 databases (PubMed, Web of Science, EMBASE, and Global Health) with predetermined search terms for relevant articles. Two reviewers then independently screened studies using a priori exclusion criteria, yielding a total of 23 articles included in the final review. We evaluated evidence from observational studies assessing animal-dependent livelihoods and livestock ownership, and interventions that promoted livestock and fish production. We found little consistency in anemia outcomes across the several AHC exposures and population groups. Poultry production interventions had modest benefits on anemia among women and children, although whether these improvements were a result of increased ASF consumption, or a result of the combined treatment study design could not be determined. Observational studies identified chicken ownership, and no other livestock species, as a risk factor for anemia among young children. However, there was limited evidence to evaluate pathways underlying these associations. Studies tended to rely on self-reported fever and diarrhea to assess illness, and no study directly assessed linkages between AHC, pathogen burden, and anemia. Thus, there is insufficient evidence to conclude whether AHC improves or worsens anemia among women and children in LMICs. Given the current interest in promoting animal production among low-income households, future studies with robust measures of livestock ownership, ASF consumption, pathogen burden, and anemia status are needed to understand the nuances of this complex and potentially contradictory relation.
Highlights
Animals play an integral role in the livelihoods of people around the world
Anemia affects over 800 million women and young children globally, with the highest prevalences occurring in Sub-Saharan Africa and South-East Asia [8]
The included studies were grouped into 3 categories which emerged based on the type of study conducted: 1) observational studies assessing anemia status between communities or regions with differing AHC-related livelihoods (n = 8), 2) observational studies assessing the association between AHC and anemia (n = 6), and 3) AHC intervention studies (n = 9) (Table 1)
Summary
For the nearly 1 billion rural poor living in Sub-Saharan Africa and South Asia that raise livestock [1] and the approximately 160 million people engaged in fishrelated activities [2], animals are a source of income, food,. Arthropod vectors and fecal contamination of the local environment [5, 6] Such zoonotic infections in humans, which involve microbe transmission cycles among animals and “spillover” to humans, significantly contribute to the human disease burden in LMICs, in resourcepoor environments where animals and humans live in close proximity [7]. Engagement in AHC may increase exposure to several anemia-inducing pathogens, including: a) Plasmodium species [12] which destroy erythrocytes, suppress erythrocyte production, and induce hepcidin-mediated iron sequestration, manifesting as malaria [13]; b) soil-transmitted helminths and Schistosoma species [5, 14] which cause blood loss [15, 16]; and c) enteropathogenic bacteria [17, 18], hypothesized contributors to inflammatory signals that induce iron sequestration, reduce iron absorption, and reduce erythropoiesis [19] (Figure 1)
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