Micronutrient deficiencies in South African infants and the effect of a micronutrient-fortified complementary food on their nutritional status, growth and development

Consequences of micronutrient deficiencies in infants often include linear growth retardation, impaired psychomotor development and reduced appetite. Fortification of complementary food is one way of addressing micronutrient deficiencies in this age group. Knowledge about these deficiencies, food consumption patterns and appetite in infants is essential in planning micronutrient fortification intervention studies. In this thesis four studies are described, two of which studied the prevalence of micronutrient deficiency and linear growth retardation in rural and urban disadvantaged South African infants. The third study determined the adequacy of the appetite of infants at the age of 6 months. The final study is an intervention study with the aim to study the effect of a micronutrient fortified complementary food on the nutritional status, growth and development of 6-12-month-old poor urban infants.The results from the first two studies showed a high prevalence of vitamin A, iron and zinc deficiency in both rural and urban infants. The low socio-economic status of the urban community and sub-optimal feeding practices may explain the similarity of deficiencies observed between rural and urban infants. The third study demonstrates that appetite was adequate in infants at the age of 6 months and not yet affected by micronutrient deficiencies. The consumption of a micronutrient-fortified complementary food appeared to reduce the decline in both serum retinol and iron concentrations in the experimental group. No effect was observed on serum zinc concentration, linear growth and psychomotor development.In conclusion, the findings of this study demonstrate similar levels of nutritional deficiencies in both poor urban and rural children. Significant differences between urban disadvantaged coloured and black infants with respect to micronutrient deficiencies and linear growth exist. This highlights the importance of including assessment of micronutrient status in addition to anthropometric measurements when assessing nutritional status. The observation of an adequate appetite in infants at the age of 6 months is important for the introduction of micronutrient-fortified complementary food. The observed positive effect of a micronutrient-fortified complementary food on serum retinol and iron concentrations in 6-12-month-old infants should be investigated further.</p

Changes in complementary feeding practices and nutrition status in returnee children aged 6-23 months in northern Uganda

Objectives: Evaluate changes in underweight and wasting, feeding patterns, water use, sanitation, immunisation, disease episodes, deworming and vitamin A supplementation in children aged 6-23 months in returnee villages benefiting from a community-based supplementary feeding programme in northern Uganda. Community perceptions on the causes and effects of childhood malnutrition, the use of community volunteers, the involvement of the men in the promotion of child nutrition and changes in childhood nutrition and feeding practices were also assessed.Design: Programme impact evaluation.Setting: The study was carried out in the districts of Pader and Agago in northern Uganda.Subjects: Children aged 6-23 months (207), and adult men and women.Outcome measures: Weight and mid-upper-arm circumference were used to determine underweight and wasting, respectively. Immunisation, deworming and vitamin A supplementation status was assessed. Oedema and morbidity or disease episodes were also determined. Community perceptions on the quality, utilisation and types of supplementary feeding services offered, understanding of malnutrition and the involvement of the men were also assessed. Finally, the impact of mother care groups and village health teams, as well as changes in child nutrition status and feeding, were assessed.Results: The prevalence of wasting (11.1%) and underweight (22.7%) is higher than the baseline of 11% and 17.8%, respectively. Eighty-six per cent of the children were still breastfeeding. A high percentage (79.2%) of children were exclusively breastfed. The largest proportion of children (42.3%) ate two times a day, and 55.6% of them consumed food from their own plates. Over three quarters (75.8%) and 93.7% of the children had received measles and diphtheria, pertussis and tuberculosis vaccines (DPT3), respectively. Ninety-five per cent and 66.7% had received vitamin A supplements and deworming tablets, respectively. The water usage rate was 19.2 l/person/day. Sixty per cent of the households had their own pit latrines. The programme was perceived to have improved the nutritional knowledge and feeding practices of the community. The use of volunteer mothers for nutrition education encouraged other community members to take childhood nutrition seriously.Conclusion: Childhood wasting and underweight rates have remained high in the two districts, despite an improvement in nutrition-related knowledge and practices. Advances in complementary feeding and related sanitation practices were recorded. An increase in vitamin A supplementation, with reductions in DPT3 immunisation and deworming were observed at the end of this community-based supplementary feeding programme. Community volunteers, through the provision of education and the identification of malnourished children, were pivotal in changing nutrition knowledge and the attitudes of community members. The support of volunteers with savings, loans and seeds were important incentives when promoting nutrition. Given the reliance of the volunteers on incentives from the project, we are sceptical as to whether nutrition education and the screening of acutely malnourished children will continue in these  communities post the project.Keywords: complementary feeding, nutritional status, behaviour, practices, children, 6-23 month

Significance of Brettanomyces and Dekkera during Winemaking: A Synoptic Review

Wine comprises a complex microbial ecology of opportunistic microorganisms, some of which could potentially inducespoilage and result in consequent economic losses under uncontrolled conditions. Yeasts of the genus Brettanomyces,or its teleomorph Dekkera, have been indicated to affect the chemical composition of the must and wine by producingvarious metabolites that are detrimental to the organoleptic properties of the final product. These yeasts can persistthroughout the harsh winemaking process and have in recent years become a major oenological concern worldwide.This literature review summarises the main research focus areas on yeasts of the genera Brettanomyces and Dekkerain wine. Specific attention is given to the spoilage compounds produced, the methods of detection and isolation fromthe winemaking environment and the factors for controlling and managing Brettanomyces spoilage

Food Waste Within South Africa and Saudi Arabia

The food waste reduction potential within the countries of the Middle East and Africa is large and understudied. Countries in the region are faced with food security and sovereignty issues, with over 50% of food imported in some countries. Due to the many differences in this region, this chapter highlights the state of food waste in two prominent countries: South Africa and Saudi Arabia. Both South Africa and Saudi Arabia have their own food waste challenges and solutions. This chapter summarises the current state of food waste research in each country, and reports the estimated volumes of food waste in South Africa and Saudi Arabia along with any notable policy developments

Market Integration Shape Organic Farmers’ Organisation

Increasing consumption of organic products in globalised food chains will require the involvement of thousands more smallholder farmers in many regions of the world. A study of Egypt, China and Uganda identified the three key factors of property rights regimes, cultural differences and social organisation as determents of the supply chain organization and farmers’ degree of direct integration in the export markets. Patterns are emerging where smallholder farmers are being socially and economically linked to larger farmers who may do some processing before the raw materials are handed over to the contracting company. Where transactions costs are high, local communities may develop and contract out the land directly to exporting companies who farm using employees. Four organisational patterns are identified which each leads to different types of livelihood benefits for the producers; preliminary results indicate that income and a reliable market access is the dominant benefits

A breath of relief: High-flow nasal oxygen in a resource-limited setting.

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Primary health care facility infrastructure and services and the nutritional status of children 0 to 71 months old and their caregivers attending these facilities in four rural districts in the Eastern Cape and KwaZulu-Natal provinces, South Africa

Objective: To assess primary health care (PHC) facility infrastructure and services, and the nutritional status of 0 to 71-month-old children and their caregivers attending PHC facilities in the Eastern Cape (EC) and KwaZulu-Natal (KZN) provinces in South Africa. Design: Cross-sectional survey. Setting: Rural districts in the EC (OR Tambo and Alfred Nzo) and KZN (Umkhanyakude and Zululand). Subjects: PHC facilities and nurses (EC: n = 20; KZN: n = 20), and 0 to 71-month-old children and their caregivers (EC: n = 994; KZN: n = 992). Methods: Structured interviewer-administered questionnaires and anthropometric survey. Results: Of the 40 PHC facilities, 14 had been built or renovated after 1994. The PHC facilities had access to the following: safe drinking water (EC: 20%; KZN: 25%); electricity (EC: 45%; KZN: 85%); flush toilets (EC: 40%; KZN: 75%); and operational telephones (EC: 20%; KZN: 5%). According to more than 80% of the nurses, problems with basic resources and existing cultural practices influenced the quality of services. Home births were common (EC: 41%; KZN: 25%). Social grants were reported as a main source of income (EC: 33%; KZN: 28%). Few households reported that they had enough food at all times (EC: 15%; KZN: 7%). The reported prevalence of diarrhoea was high (EC: 34%; KZN: 38%). Undernutrition in 0 to younger than 6 month-olds was low; thereafter, however, stunting in children aged 6 to 59 months (EC: 22%; KZN: 24%) and 60 to 71 months (EC: 26%; KZN: 31%) was medium to high. Overweight and obese adults (EC: 49%; KZN: 42%) coexisted. Conclusion: Problems regarding infrastructure, basic resources and services adversely affected PHC service delivery and the well-being of rural people, and therefore need urgent attention.Keywords: primary health care facilities; nutritional status; children; caregivers’ rural; South Afric

African leafy vegetables in South Africa

In this article the term ‘African leafy vegetables’ was adopted to refer to the collective of plant species which are used as leafy vegetables and which are referred to as morogo or imifino by African people in South Africa. Function is central in this indigenous concept, which is subject to spatial and temporal variability in terms of plant species that are included as a result of diversity in ecology, culinary repertoire and change over time. As a result, the concept embraces indigenous, indigenised and recently introduced leafy vegetable species but this article is concerned mainly with the indigenous and indigenised species. In South Africa, the collection of these two types of leafy vegetables from the wild, or from cultivated fields where some of them grow as weeds, has a long history that has been intimately linked to women and their traditional livelihood tasks. Among poor people in remote rural areas the use of these types of leafy vegetables is still common but nationwide there is evidence of decline, particularly in urban areas. Cultivation of indigenous or indigenised leafy vegetables is restricted to a narrow group of primarily indigenised species in South Africa. Seven groups of indigenous or indigenised African leafy vegetables that are important in South Africa were given special attention and their local nomenclature, ecology, use and cultivation are discussed.Keywords: African leafy vegetables, morogo, imifino, history, ecology, gender, collection, cultivation, use, processing, storag

African leafy vegetables in South Africa

In this article the term ‘African leafy vegetables’ was adopted to refer to the collective of plant species which are used as leafy vegetables and which are referred to as morogo or imifino by African people in South Africa. Function is central in this indigenous concept, which is subject to spatial and temporal variability in terms of plant species that are included as a result of diversity in ecology, culinary repertoire and change over time. As a result, the concept embraces indigenous, indigenised and recently introduced leafy vegetable species but this article is concerned mainly with the indigenous and indigenisedspecies. In South Africa, the collection of these two types of leafy vegetables from the wild, or from cultivated fields where some of them grow as weeds, has a long history that has been intimately linked to women and their traditional livelihood tasks. Among poor people in remote rural areas the use of these types of leafy vegetables is still common but nationwide there is evidence of decline, particularly in urban areas. Cultivation of indigenous or indigenised leafy vegetables is restricted to a narrow group of primarily indigenised species in South Africa. Seven groups of indigenous or indigenised African leafyvegetables that are important in South Africa were given special attention and their local nomenclature, ecology, use and cultivation are discussed