Protective Effect Of Living With Animals On Diarrheal Illness Among Children Younger Than Five In Sub-Saharan Africa And South Asia

Abstract Background Diarrheal disease is one of the top three causes of death in children <5 years old, with the majority occurring in sub-Saharan Africa and South Asia. Animals are known reservoirs of diarrheal pathogens. While previous studies have investigated companion animals and livestock as contributors to human diarrheal disease, few have investigated this association in sub-Saharan Africa and/or South Asia among children younger than 5 years old. The aim of this study was to determine the relationship between animals living in or near the home and diarrheal disease in this population. Methods We conducted a secondary analysis of the Global Enteric Multicenter Study (GEMS), a case–control study that described the epidemiology of and evaluated the risk factors for diarrheal illness in children <5 years old living in sub-Saharan Africa and South Asia. Children with moderate-to-severe diarrhea (MSD) were matched to community controls without diarrhea. Associations between the predictor of animals present in a child’s living environment and the outcomes of diarrhea and diarrheal pathogens were assessed using multivariable conditional logistic regression with alpha = 0.05. Known risk factors for MSD were assessed for confounding. Results From December 1, 2007 to March 3, 2011, there were 9,439 cases with MSD and 13,128 controls enrolled in GEMS. 87% of children had at least 1 animal present at their home. When controlling for exclusive breastfeeding, access to an improved water source, access to a private improved sanitation facility, and the number of children <5 living in the home, children were less likely to have MSD if there was at least one animal present at their home (aOR 0.66, CI95 0.59 – 0.74). Children living with an animal were also 15% less likely to be colonized or infected with a viral diarrheal pathogen (aOR 0.85, CI95 0.72–0.99), when controlling for exclusive breastfeeding. There were no significant differences in the presence of bacterial or protozoal pathogens in the stool of children with and without animals present at their home. Conclusion In contrast to prior research, having an animal present at the home does not appear to increase the risk of childhood diarrhea. Furthermore, the presence of animals may have a protective effect against viral diarrheal disease in young children. Additional research is needed to gain greater understanding of this relationship. Disclosures All authors: No reported disclosures.