Abstract
Although strategic thinking on water, sanitation and hygiene (WASH) has prioritized reducing exposure to human feces in order to limit diarrheal infections, recent research suggests that elevated exposure to livestock–particularly poultry and poultry feces–may be an important risk factor for diarrhea, environmental enteric disorder (EED) and respiratory infections, all of which may seriously retard linear growth in young children. Yet a very different literature on nutrition-sensitive agriculture suggests that livestock ownership is highly beneficial for child growth outcomes through its importance for increasing consumption of nutrient-rich animal sourced foods, such as eggs. Together, these two literatures suggest that the net nutritional benefit of poultry ownership is particularly ambiguous and potentially mediated by whether or not children are highly exposed to poultry. We test this novel hypothesis using a large agricultural survey of rural Ethiopian households that includes measures of child height-for-age Z-scores (HAZ), ownership of poultry and other types of livestock, and an indicator of whether livestock are kept within the main household dwelling overnight. We used least squares regression analysis to estimate unadjusted and adjusted models that control for a wide range of potentially confounding factors. We find that while poultry ownership is positively associated with child HAZ [β = 0.291, s.e. = 0.094], the practice of corralling poultry in the household dwelling overnight is negatively associated with HAZ [β = -0.250, s.e. = 0.118]. Moreover, we find no negative associations between HAZ and corralling other livestock species indoors. These results suggest that while poultry ownership can be beneficial to child growth, overly close exposure to poultry poses a concurrent risk factor for undernutrition, most likely because of increased risk of infection.
Highlights
Child undernutrition in poor countries has long been linked to disease burdens such as diarrhea and respiratory infections, but more recently to environmental enteric disorder (EED), a sub-clinical condition characterized by chronic damage to the gut, malabsorption of nutrientsPLOS ONE | DOI:10.1371/journal.pone.0160590 August 16, 2016Gates Foundation
This paper engaged in an observational analysis of the novel hypothesis that the otherwise positive relationship between poultry ownership and child nutrition is negatively mediated by a child’s physical proximity to poultry, as operationalized by whether a household keeps poultry indoors overnight
The results reported in the previous section are consistent with this hypothesis. These associations should not be interpreted too literally, the negative association between close physical exposure to poultry and child growth is large in magnitude, and not statistically different in magnitude from the positive association between poultry ownership and growth
Summary
Child undernutrition in poor countries has long been linked to disease burdens such as diarrhea and respiratory infections, but more recently to environmental enteric disorder (EED), a sub-clinical condition characterized by chronic damage to the gut, malabsorption of nutrients. In addition to this formative research, two papers from the Global Enteric Multicenter Study in the Mirzapur sub-district of Bangladesh linked EED and stunting with maternal reports of geophagy [18] and keeping poultry inside the room where young children sleep [19] In addition to this recent literature on the hygiene dimensions of livestock ownership, there is a re-emerging literature on the important of animal sourced foods (ASFs) for child nutrition in developing countries [20,21,22,23,24,25], as well as several studies that have attempted to more directly assess the impact of livestock ownership on child nutrition, dairy cattle [26,27,28]. These three supplementary tests can shed light on whether the positive associations between HAZ and poultry ownership stem from direct effects on egg consumption and/or more generic linkages between household wealth and poultry ownership (linkages which could be bi-directional)
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