Background: 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
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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 (ß= 0.006 SD, 95% CI -0.02, 0.04) or
prospective monthly child growth rate (ß=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 ß= -0.045,
95% CI -0.186, 0.096; over 2 years ß=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
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health improvement are integrated, provides approaches to prevent disease in livestock may
promote optimal child growth and nutrition in rural households.