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A One Health Approach to Child Stunting: Evidence and Research Agenda

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  • 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • 2 Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom;
  • 3 International Livestock Research Institute, Addis Ababa, Ethiopia;
  • 4 Department of Evolution, Ecology and Behaviour, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom;
  • 5 Central Veterinary Laboratory, Harare, Zimbabwe;
  • 6 College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom;
  • 7 School of Veterinary Medicine, University of Zambia, Lusaka, Zambia;
  • 8 Food and Agriculture Organization of the United Nations, Harare, Zimbabwe;
  • 9 Blizard Institute, Queen Mary University of London, London, United Kingdom;
  • 10 Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe;
  • 11 United Nations Children’s Fund, Harare, Zimbabwe;
  • 12 School of Geography, Queen Mary University of London, London, United Kingdom;
  • 13 Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York;
  • 14 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

ABSTRACT

Stunting (low height for age) affects approximately one-quarter of children aged < 5 years worldwide. Given the limited impact of current interventions for stunting, new multisectoral evidence-based approaches are needed to decrease the burden of stunting in low- and middle-income countries (LMICs). Recognizing that the health of people, animals, and the environment are connected, we present the rationale and research agenda for considering a One Health approach to child stunting. We contend that a One Health strategy may uncover new approaches to tackling child stunting by addressing several interdependent factors that prevent children from thriving in LMICs, and that coordinated interventions among human health, animal health, and environmental health sectors may have a synergistic effect in stunting reduction.

Author Notes

Address correspondence to Radhika Gharpure, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 600 Clifton Rd. NE, Mailstop H24-10, Atlanta, GA 30329. E-mail: rgharpure@cdc.gov

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of their institutions.

Financial support: The May 2019 meeting was funded by the U.K. Medical Research Council (grant MC_PC_MR/R019436/1). A. J. P., R. C. R., and C. E. received funds from the Wellcome Trust (grants 108065/Z/15/Z, 206455/Z/17/Z, and 203905/Z/16/Z).

Authors’ addresses: Radhika Gharpure and David Berendes, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: krr4@cdc.gov and uws8@cdc.gov. Siobhan Mor, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom, E-mail: siobhan.mor@liverpool.ac.uk. Mark Viney, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom, E-mail: mark.viney@liverpool.ac.uk. Tinashe Hodobo, Central Veterinary Laboratory, Harare, Zimbabwe, E-mail: tinashehdb@gmail.com. Joanne Lello and Cedric Berger, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom, E-mails: lelloj@cardiff.ac.uk and bergerc3@cardiff.ac.uk. Joyce Siwila, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia, E-mail: siwilaj@yahoo.co.uk. Kululeko Dube and Patience Hoto, Food and Agriculture Organization of the United Nations, Harare, Zimbabwe, E-mails: kululeko.dube@fao.org and patience.hoto@fao.org. Ruairi C. Robertson, Ceri Evans, and Andrew J. Prendergast, Blizard Institute, Queen Mary University of London, London, United Kingdom, E-mails: r.robertson@qmul.ac.uk, ceri.evans@qmul.ac.uk, and a.prendergast@qmul.ac.uk. Mitsuaki Hirai and Mathieu Joyeux, UNICEF, Harare, Zimbabwe, E-mails: mhirai@unicef.org and mjoyeux@unicef.org. Tim Brown, School of Geography, Queen Mary University of London, London, United Kingdom, E-mail: tim.brown@qmul.ac.uk. Kuda Mutasa, Robert Ntozini, Laura E. Smith, Naume V. Tavengwa, and Jean H. Humphrey, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe, E-mails: k.mutasa@zvitambo.com, r.ntozini@zvitambo.com, lesmith6@buffalo.edu, n.tavengwa@zvitambo.com, and jhumphr2@jhu.edu.

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