Child height gain is associated with consumption of animal-source foods in livestock-owning households in Western Kenya

OBJECTIVE: To clarify the pathways between household livestock and child growth by assessing the relationships between consumption of animal-source foods (ASF) and child growth and evaluating the household livestock correlates of child consumption of ASF. DESIGN: We conducted a longitudinal cohort study of anthropometry and 3 d feeding recalls among children <5 years old between June 2014 and May 2015. In addition, we collected data on wealth, livestock ownership and livestock diseases in the same households. We used linear and negative binomial mixed models to evaluate the relationships between household livestock characteristics, reported consumption of ASF and child growth. SETTING: An 1800-household surveillance catchment area in Western Kenya within the structure of human and animal health surveillance systems. SUBJECTS: Children (n 874) <5 years old. RESULTS: Among children >6 months old, reported frequency of egg and milk consumption was associated with increased monthly height gain (for each additional report of consumption over 3 d: adjusted β (95% CI) = 0·010 (0·002, 0·019) cm/month and 0·008 (0·004, 0·013) cm/month, respectively). Poultry ownership was associated with higher reported frequency of egg, milk and chicken consumption (adjusted incidence rate ratio (95% CI) = 1·3 (1·2, 1·4), 1·4 (1·1, 1·6) and 1·3 (1·1, 1·4), respectively). Some livestock diseases were associated with lower reported frequency of ASF intake (livestock digestive Child growth diseases-adjusted incidence rate ratio (95% CI) = 0·89 (0·78, 1·00)). CONCLUSIONS: Child height gain was associated with milk and egg consumption in this cohort. ASF consumption was related to both household livestock ownership and animal health

Microbiome sharing between children, livestock and household surfaces in western Kenya

The gut microbiome community structure and development are associated with several health outcomes in young children. To determine the household influences of gut microbiome structure, we assessed microbial sharing within households in western Kenya by sequencing 16S rRNA libraries of fecal samples from children and cattle, cloacal swabs from chickens, and swabs of household surfaces. Among the 156 households studied, children within the same household significantly shared their gut microbiome with each other, although we did not find significant sharing of gut microbiome across host species or household surfaces. Higher gut microbiome diversity among children was associated with lower wealth status and involvement in livestock feeding chores. Although more research is necessary to identify further drivers of microbiota development, these results suggest that the household should be considered as a unit. Livestock activities, health and microbiome perturbations among an individual child may have implications for other children in the household

The relationship between livestock ownership and child stunting in three countries in eastern Africa using national survey data

Livestock ownership has the potential to improve child nutrition through various mechanisms, although direct evaluations of household livestock and child stunting status are uncommon. We conducted an analysis of Demographic and Health Survey (DHS) datasets from Ethiopia (2011), Kenya (2008-2009), and Uganda (2010) among rural children under 5 years of age to compare stunting status across levels of livestock ownership. We classified livestock ownership by summing reported household numbers of goats, sheep, cattle and chickens, as well as calculating a weighted score to combine multiple species. The primary association was assessed separately by country using a log-binomial model adjusted for wealth and region, which was then stratified by child diarrheal illness, animal-source foods intake, sub-region, and wealth index. This analysis included n = 8079 children from Ethiopia, n = 3903 children from Kenya, and n = 1645 from Uganda. A ten-fold increase in household livestock ownership had significant association with lower stunting prevalence in Ethiopia (Prevalence Ratio [PR] 0.95, 95% CI 0.92-0.98) and Uganda (PR 0.87, 95% CI 0.79-0.97), but not Kenya (PR 1.01, 95% CI 0.96-1.07). The weighted livestock score was only marginally associated with stunting status. The findings varied slightly by region, but not by wealth, diarrheal disease, or animal-source food intake. This analysis suggested a slightly beneficial effect of household livestock ownership on child stunting prevalence. The small effect size observed may be related to limitations of the DHS dataset or the potentially complicated relationship between malnutrition and livestock ownership, including livestock health and productivity

The influence of livestock ownership and health on the nutritional status of children in Eastern Africa

Thesis (Ph.D.)--University of Washington, 2015Background: In many rural low-resource settings, chronic malnutrition-induced linear growth faltering is widely prevalent. In these same areas, household livestock ownership is ubiquitous. Livestock may positively or negatively influence nutritional status through a variety of pathways, including improving food security but also increasing exposure to infectious diseases. We sought to determine whether 1) livestock ownership and 2) livestock disease were associated with growth outcomes among children under five years of age in Eastern Africa. Methods: We used two data sources to address these aims. To test whether livestock ownership influenced child growth outcomes, as measured by stunting prevalence (<-2 standard deviations of Height-for-Age Z-score), we first analyzed the most recent Demographic and Health Surveys (DHS) for Ethiopia (2011), Kenya (2008-2009), and Uganda (2011). We also evaluated the question of livestock ownership and child growth within an ongoing Kenya Medical Research Institute (KEMRI)-Centers for Disease Control (CDC) demographic and health surveillance cohort in rural Western Kenya. The cohort monitors both human and livestock disease, and our team incorporated monthly anthropometry measurements for children. Using data from both the DHS and the surveillance cohort, we tested whether higher numbers of livestock ownership were associated with child nutrition outcomes using linear regression models clustered by household. To assess whether livestock health status was associated with child growth outcomes, we used the Western Kenya surveillance data to evaluate each child’s overall and time-varying exposure to livestock disease and subsequent growth using linear mixed regression models. Results: The DHS analysis included n=8079 children from Ethiopia, n= 3903 children from Kenya, and n=1645 from Uganda. A ten-fold increase in household livestock ownership was significantly associated with lower stunting prevalence in Ethiopia (Prevalence Ratio [PR] 0.95, 95% CI 0.92-0.98) and in Uganda (PR 0.87, 95% CI 0.79-0.97), but not in Kenya (PR 1.01, 95% CI 0.96-1.07). In the surveillance cohort in Western Kenya, we monitored the growth of 1097 children at least once over the course of 11 months. Higher household livestock ownership at baseline was not related to baseline child height-for-age z-score (β= 0.006 SD, 95% CI -0.02, 0.04) or prospective monthly child growth rate (β=0.002cm, 95% CI -0.003, 0.006). Further, over the entire duration of follow-up, higher numbers of any livestock disease in a household was not related to average 6 monthly growth rate of children in the same household (under 2 β= -0.045, 95% CI -0.186, 0.096; over 2 years β=0.006, 95% CI-0.031, 0.044). However, in the time-varying models of acute livestock disease and 3-month child growth intervals, we observed a trend by which children grew less after exposure to livestock disease, particularly among those children under age two. Conclusion: The DHS analysis for Ethiopia, Kenya, and Uganda demonstrated a small beneficial impact of livestock ownership on reducing child stunting. The small effect size may be related to limitations of the DHS dataset or the potentially complicated relationship between malnutrition and livestock ownership, including livestock health and productivity. In the cohort of children in Western Kenya, ownership of livestock did not appear to be significantly associated with improvements in linear growth. However, disease in livestock may be associated with short term growth detriment. One Health, a concept by which human, animal, and environmental health improvement are integrated, provides approaches to prevent disease in livestock may promote optimal child growth and nutrition in rural households

sj-docx-1-phr-10.1177_00333549241228525 – Supplemental material for Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022

Supplemental material, sj-docx-1-phr-10.1177_00333549241228525 for Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022 by Caroline J. Waddell, Carlos S. Saldana, Megan M. Schoonveld, Ashley A. Meehan, Christina K. Lin, Jay C. Butler and Emily Mosites in Public Health Reports</p

Estimating the Burden of Paratyphoid A in Asia and Africa

<div><p>Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both <i>Salmonella enterica</i> serovar Typhi (<i>S.</i> Typhi) and serovar Paratyphi (<i>S.</i> Paratyphi) cause enteric fever, limited data exist estimating the burden of <i>S.</i> Paratyphi, particularly in Asia and Africa.</p> <p>We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed <i>Salmonella</i> serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study.</p> <p>A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden.</p> <p>While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by <i>S.</i> Paratyphi A, and to improve the prevention and treatment of enteric fever.</p> </div

Household and child characteristics from Ethiopia 2011, Kenya 2008–2009 and Uganda 2010 Demographic and Health Surveys (DHS).

<p>^a Standard deviation (SD)</p><p>^bAmong households which own any animals</p><p>^c No animals are included in the wealth score</p><p>^d Defined as height-for-age z-score lower than 2 standard deviations below the reference mean</p><p>Household and child characteristics from Ethiopia 2011, Kenya 2008–2009 and Uganda 2010 Demographic and Health Surveys (DHS).</p

English-language systematic search results of <i>S.</i> Paratyphi A burden, articles published 2005–2013.

<p>English-language systematic search results of <i>S.</i> Paratyphi A burden, articles published 2005–2013.</p

Epidemiology of Hookworm Infection in Kintampo North Municipality, Ghana: Patterns of Malaria Coinfection, Anemia, and Albendazole Treatment Failure

A cross-sectional pilot study of hookworm infection was carried out among 292 subjects from 62 households in Kintampo North, Ghana. The overall prevalence of hookworm infection was 45%, peaking in those 11–20 years old (58.5%). In children, risk factors for hookworm infection included coinfection with malaria and increased serum immunoglobulin G reactivity to hookworm secretory antigens. Risk factors for infection in adults included poor nutritional status, not using a latrine, not wearing shoes, and occupation (farming). Although albendazole therapy was associated with an overall egg reduction rate of 82%, 37 subjects (39%) remained infected. Among those who failed therapy, treatment was not associated with a significant reduction in egg excretion, and nearly one-third had higher counts on repeat examination. These data confirm a high prevalence of low-intensity hookworm infection in central Ghana and its association with poor nutritional status. The high rate of albendazole failure raises concern about emerging resistance