Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI.
Adv Nutr. 2019 Mar 1;10(2):331-344. doi: 10.1093/advances/nmy080.
Animal 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.
畜牧业和捕捉（AHC）可以通过提供富含微量营养素的动物源食品（ASF）来缓解妇女和儿童的贫血问题，但同时也可能增加感染贫血诱导病原体的风险，如疟原虫、寄生虫和肠道病原体。我们进行了系统的文献回顾，以评估 AHC 与低中收入国家（LMIC）育龄妇女、学龄儿童和 5 岁以下儿童贫血之间的关系。我们使用了两阶段筛选过程，其中一名审查员使用预定的搜索词在四个数据库（PubMed、Web of Science、EMBASE 和 Global Health）中搜索相关文章。然后，两名审查员使用预先确定的排除标准独立筛选研究，最终共有 23 篇文章纳入最终综述。我们评估了评估动物依赖生计和牲畜所有权的观察性研究以及促进牲畜和鱼类生产的干预措施的证据。我们发现，几种 AHC 暴露和人群组的贫血结果不一致。家禽生产干预措施对妇女和儿童的贫血有一定的益处，尽管这些改善是由于 ASF 消费增加还是由于联合治疗研究设计尚不清楚。观察性研究确定了鸡的所有权，而没有其他牲畜种类，是幼儿贫血的一个危险因素。然而，评估这些关联背后的途径的证据有限。研究往往依赖于自我报告的发热和腹泻来评估疾病，并且没有研究直接评估 AHC、病原体负担和贫血之间的联系。因此，没有足够的证据可以得出结论，AHC 是否改善或恶化了 LMIC 中妇女和儿童的贫血状况。鉴于目前人们对促进低收入家庭的动物生产感兴趣，未来需要进行具有牲畜所有权、ASF 消费、病原体负担和贫血状况的可靠措施的研究，以了解这种复杂且潜在矛盾关系的细微差别。
