The impact of a Solar Market Garden programme on dietary diversity, women's nutritional status and micronutrient levels in Kalalé district of northern Benin.

ObjectiveTo examine the impacts of a Solar Market Garden 1-year solar-powered drip irrigation (SMG) programme in Kalalé district of northern Benin on mothers' nutritional status and micronutrient levels.DesignUsing a quasi-experimental design, sixteen villages were assigned to four groups: (i) SMG women's groups (WG); (ii) comparison WG; (iii) SMG non-WG (NWG); and (iv) comparison NWG. Difference-in-differences (DID) estimates were used to assess impacts on mothers' food consumption, diversity, BMI, prevalence of underweight (BMI < 18·5 kg/m2) and anaemia, and deficiencies of iron (ID) and vitamin A (VAD).SettingKalalé district, northern Benin.ParticipantsNon-pregnant mothers aged 15-49 years (n 1737).ResultsThe SMG programme significantly increased mothers' intake of vegetables (DID = 25·31 percentage points (pp); P < 0·01), dietary diversity (DID = 0·74; P < 0·01) and marginally increased their intake of flesh foods (DID = 10·14 pp; P < 0·1). Mean BMI was significantly increased among SMG WG compared with the other three groups (DID = 0·44 kg/m2; P < 0·05). The SMG programme also significantly decreased the prevalence of anaemia (DID = 12·86 pp; P < 0·01) but no impacts were found for the prevalence of underweight, ID and VAD.ConclusionsImproving mothers' dietary intake and anaemia prevalence supports the need to integrate gender-based agriculture to improve nutritional status. However, it may take more than a year, and additional nutrition and health programmes, to impact the prevalence of maternal underweight, ID and VAD

AIDS-related stigmatisation in the healthcare setting: a study of primary healthcare centres that provide services for prevention of mother-to-child transmission of HIV in Lagos, Nigeria

Objective: To assess AIDS stigmatising attitudes and behaviours by prevention of mother-to-child transmission (PMTCT) service providers in primary healthcare centres in Lagos, Nigeria. Design: Cross-sectional survey. Setting: Thirty-eight primary healthcare centres in Lagos, Nigeria. Participants: One hundred and sixty-one PMTCT service providers. Outcome measures PMTCT service providers' discriminatory behaviours, opinions and stigmatising attitudes towards persons living with HIV/AIDS (PLWHAs), and nature of the work environment (HIV/AIDS-related policies and infection-control guidelines/supplies). Results: Reported AIDS-related stigmatisation was low: few respondents (4%) reported hearing coworkers talk badly about PLWHAs or observed provision of poor-quality care to PLWHAs (15%). Health workers were not worried about secondary AIDS stigmatisation due to their occupation (86%). Opinions about PLWHAs were generally supportive; providers strongly agreed that women living with HIV should be allowed to have babies if they wished (94%). PMTCT service providers knew that consent was needed prior to HIV testing (86%) and noted that they would get in trouble at work if they discriminated against PLWHAs (83%). A minority reported discriminatory attitudes and behaviours; 39% reported wearing double gloves and 41% used other special infection-control measures when providing services to PLWHAs. Discriminatory behaviours were correlated with negative opinions about PLWHAs (r=0.21, p<0.01), fear of HIV infection (r=0.16, p<0.05) and professional resistance (r=0.32, p<0.001). Those who underwent HIV training had less fear of contagion. Conclusions: This study documented generally low levels of reported AIDS-related stigmatisation by PMTCT service providers in primary healthcare centres in Lagos. Policies that reduce stigmatisation against PLWHA in the healthcare setting should be supported by the provision of basic resources for infection control. This may reassure healthcare workers of their safety, thus reducing their fear of contagion and professional resistance to care for individuals who are perceived to be at high risk of HIV.Fulbright Scholar program, a program of the United States Department of State, Bureau of Educational and Cultural AffairsOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Community Health Workers in Diabetes Prevention and Management in Developing Countries

BackgroundThere is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs.MethodsTo identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Group's Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017.FindingsTen studies were included (4 pre- and post-studies, 2 randomized controlled trials, 2 cohort studies, 1 cross-sectional study, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of social support through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes.ConclusionsCHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time

Évaluation d'une intervention nutritionnelle visant à prévenir l'anémie ferriprive chez des adolescentes pensionnaires au Bénin

Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2008-2009Des prélèvements sangums et de selles, un questionnaire sur la fréquence de consommation des aliments riches en fer et en vitamine C, un questionnaire général portant sur les aspects socio-économiques et sanitaires, ainsi que sur les connaissances nutritionnelles ont été administrés à 180 adolescentes béninoises âgées de 12 à 17 ans pensionnaires au lycée Toffa 1 er (n=80) et au CEG1 de Ouidah (n=100). La prévalence d'anémie, de carence en fer et d'anémie ferriprive était respectivement de 50,6, 31 , 7 et 23,9%. Les connaissances nutritionnelles et la consommation d'aliments riches en fer et en vitamine C étaient faibles. L'anémie ferriprive était plus élevée chez les adolescentes issues d'une famille >5. personnes et dont la mère occupait un travail manuel. Des 180 adolescentes sélectionnées précédemment, 34 filles du lycée Toffa 1er souffrant d'anémie ferriprive légère ont constitué le groupe d' intervention et ont été soumises à une intervention nutritionnelle comprenant 4 leçons d'éducation nutritionnelle et un menu riche en fer biodisponible à la cafétéria scolaire (apport médian cible de l , 90 mg) pendant 22 semaines, tandis que le groupe témoin a continué à s' alimenter de façon habituelle (n=34, CEG 1 de Ouidah). Des prélèvements sanguins et de selles, ainsi que des rappels de 48 heures ont été effectués en pré et en post-intervention. Le groupe témoin a bénéficié d'une formule sanguine après Il semaines afin d' éliminer les sujets souffrant d'anémie ferriprive modérée ou sévère. En post-intervention, le groupe d' intervention avait des apports plus élevés en fer et en vitamine C (P<0,05) et des meilleurs scores de connaissances nutritionnelles (P<O, OOl). Le taux d'hémoglobine et la ferritine sérique étaient significativement plus élevés dans le groupe d' intervention (122,5 vs. 113,1 g/L; P=0,0002; 31 , 7 vs. 18,8 Jlg/L; P=0,04) comparativement au groupe témoin, tandis que l'anémie ferriprive était plus faible (26,5 vs. 55,9%; P=0,04). Aucune différence significative n'a été observée pour les infections parasitaires entre les 2 groupes à la fin de l'étude. Ces résultats indiquent que l'anémie ferriprive représente un problème de santé publique chez les adolescentes étudiées et qu'une éducation nutritionnelle combinée à des modifications alimentaires visant à améliorer la teneur en fer absorbable peut réduire l'anémie ferriprive

Relation entre les infections parasitaires, les apports en fer absorbable et l’anémie chez des adolescentes au Bénin

La relation entre les infections parasitaires intestinales, les apports en fer absorbable et le statut en fer a été étudiée chez 100 adolescentes béninoises âgées de 14 à 16 ans. Cinquante adolescentes vivaient en internat et 50 en externat. Les apports alimentaires ont été obtenus par un rappel de 48 heures et les apports en fer absorbable ont été estimés par le modèle de Monsen. Quarante-trois pour cent des sujets étaient anémiques, tandis que la carence en fer définie par un modèle à indices biochimiques multiples basé sur l’existence d’au moins deux paramètres anormaux parmi les quatre indicateurs utilisés (fer sérique, capacité totale de fixation du fer par la transferrine, volume globulaire moyen, concentration globulaire moyenne en hémoglobine) était présente chez 14 % des sujets. L’anémie ferriprive (hémoglobine < 120g/L + modèle à indices biochimiques multiples) était présente chez 13 % des sujets. Trente et un pour cent des adolescentes étaient atteintes d’au moins un parasite : Entamoeba hystolitica (14 %), Entamoeba coli (13 %), Entamoeba hystolitica et Entamoeba coli (3 %) et, Entamoeba coli et Trichuris trichiura (1 %). Cependant la charge était faible (3-5 kystes ou vers par lame). La prévalence des parasites était plus faible à l’internat qu’à l’externat, bien que la différence représentait seulement une tendance (p = 0,08). Aucune association significative n’a été observée entre les infections parasitaires intestinales et les indicateurs du statut de fer. En revanche, l’apport en fer absorbable total (incluant les suppléments) (p = 0,01 et p = 0,02) et le niveau socio-économique (p = 0,03 et p = 0,00004) ont été significativement liés aux concentrations d’hémoglobine et d’hématocrite respectivement. En conclusion, l’anémie était reliée aux apports en fer absorbable total chez les adolescentes étudiées, alors qu’aucun lien n’a été observé entre l’anémie et les infections parasitaires. La faible charge parasitaire observée peut expliquer l’absence d’association entre ces variables

Iron-containing cookware for the reduction of iron deficiency anemia among children and females of reproductive age in low- and middle-income countries: A systematic review.

BACKGROUND & OBJECTIVE:There is limited evidence regarding the efficacy of iron-containing pots and ingots in reducing iron deficiency (ID) and iron deficiency anemia (IDA) in low- and middle-income countries (LMICs). The objective of this systematic review is to summarize the evidence regarding the effect of iron-containing cookware on ID and IDA among children and females of reproductive age (FRA) in LMICs. METHODS:Searches were last conducted in May 2019 in PubMed, Embase, Cochrane Library, Web of Science, Scopus, CAB Abstracts, POPLINE, LILACS, ProQuest Dissertations & Theses Global, WHO ICTRP and ClinicalTrials.gov. Hand searching was also conducted. Selection criteria included randomized-controlled trials (RCTs), quasi-experimental studies and observational studies with control groups that studied the effect of iron-containing cookware in children (4 months-11 years) and females of reproductive age (12-51 years). RESULTS:Eleven studies were eligible for inclusion in the review. Statistically significant increases in hemoglobin and/or iron indices (p < 0.05) were observed in 50% (4/8) of studies on pots (relative change/mean difference in Hb: -0.4-1.20 g/dL), and 33.3% (1/3) of studies on ingots (relative change/mean difference in Hb: 0.32-1.18 g/dL). Positive outcomes (p < 0.05) were observed among children in 50% (4/8) of studies and among FRA in 28.6% (2/7) of studies. Compliance ranged from 26.7-71.4% daily use of pots to 90-93.9% daily use of ingots. CONCLUSIONS:There are indications that, with reasonable compliance, iron-containing cookware could serve as a means of reducing IDA, especially among children. The potential advantages of iron-containing cookware include relative cost-effectiveness and complementary combination with other interventions. However, further research is needed regarding both the efficacy and safety of this intervention