Complementary feeding practices and nutritional status of children 6 to 24 months: A cross-sectional descriptive study

Background: Complementary feeding refers to a process of introducing the infant to additional sources of nutrition other than the breast milk, usually at the age of six months. Infant and Young Child Feeding guidelines provided by United Nations Children’s Fund/ World Health Organization require that children are exclusively breastfed from birth to six months of age when addition foods is introduced to meet the increasing nutritional requirements of the growing child. Proper initiation of the complementary feeding is critical as any deviation may lead to inadequate energy and nutrient intake, leading to sub-optimal growth and development. Objective: The study aimed to assess complementary feeding practices in relation to nutritional status of children aged 6 to 24 months at the Well baby Clinic at Mbagathi Hospital, Nairobi County. and Methods: A cross-sectional study involving 300 children aged 6 to 24 months was conducted at the Well Baby Clinic at Mbagathi Hospital. Anthropometric measurements were taken using standard procedures and interviewer administered questionnaire was administered to mothers to gather data on complementary feeding practices of study children. Anthropometric data was analyzed using WHO anthro2005 software and descriptive statistics analyzed using SPSS version 20. Results were presented in tables. Results: Majority (81.7%) of children were first initiated complementary feeding at the recommended age of six months with a mean age of 5.71(±1.033). Almost a quarter (24.3%) of the children were given ≤ 3 meals per day with a mean of 4.35 (±1.210) meals per day. 15.3% of the children were wasted (W/H z-score <-2SD), 22% underweight (W/A z-score <-2SD) and 14.3% stunted (H/A z-score <-2SD. Most complementary foods were Carbohydrates (starchy) based from locally available cereals with limited combination from other food classifications. Conclusion and recommendation: Despite the impressive rates of compliance with the recommended age of introduction of complementary feeding, malnutrition was high among the children attending the Well Baby clinic at Mbagathi District Hospital. There is need for health care providers to proactively address gaps in complementary feeding practices especially on food diversity, food composition and frequency of meals. Key words: Complementary feeding practices, malnutrition, food quality, complementary food diversity

Improving the nutritional status of malnourished children using soybean products in Rwanda

The prevalence of malnutrition is high in Rwanda especially in Ruhango District of Southern Province (23.5% in 2009). The contribution of soybean (Glycine max L), which is an important source of high quality and inexpensive protein and oil, to improvement of nutritional status of  malnourished children is unclear. Although a lot of research has been done on the production of soybean in Rwanda, research on soybean in the diet to improve the nutritional status of malnourished children has not been done. The aim of this study was to determine the effect of soybean flour and soybean milk on the nutritional status of malnourished children under the age of five. The objective was to determine the weight gain due to each treatment in comparison with the control group. This study was conducted in Ruhango District of Southern Province Rwanda. A survey was conducted where households growing and utilizing soybean were identified and  anthropometric measurements were taken on 294 children to select malnourished children. Thirty malnourished children participate in the intervention which lasted three months. One cup (250ml) of soybean milk was supplemented to ten children per day. An equal number was  supplemented with 25g of soybean flour in soup (250ml). The caregivers of the ten children in the control group received nutrition education together with the two treatment groups. Anthropometric measurements were taken every month and entered in WHO ANTHRO software. Data was analyzed by regression models using GenStat 14th edition and the magnitude of weight gain due to each of the treatments was predicted at 5% level of  significance. A linear mixed model was used to estimate and compareweight gain among children fed on soybean milk and soybean flour supplement in comparison with the control group. Soybean products were found to affect weight gain of children (P = 0.04). The mean weight gain was 0.9 (±0.5) kg within three months of intervention. The difference in weight gain between the two treatment groups was not significant. To improve the nutritional status of malnourished children under five years further intervention is needed in terms of education and training on soybean based diet formulation.Key words: soybean products, under five, Rwand

The effects of household food practices and diseases prevalence on nutritional status of under-five children in Ruhango District, Rwanda

Malnutrition in the Southern province of Rwanda is a significant public health concern. According to the Rwanda Demographic and Health Survey (RDHS) 2010, chronic malnutrition in children under 5 years was widespread 44% children having stunting (insufficient height for age), 11 % underweight (weight for age) and 3% wasting (weight for height). Ruhango district (Southern Rwanda) had the highest malnutrition prevalence (23.5%) in 2009. This study aimed to measure the prevalence of malnutrition among Ruhango children in 2012 and to identify relationship between comorbidities occurrence, food intake and their nutrition status. A multistage sampling was done across four hierarchical levels: district, sector, cell and village, where households (N=294) with children under five years were purposively selected to form the sampling units in which the survey was conducted. The study showed that Ruhango has improved in prevention of malnutrition as compared to 2010 study. However, stunting was still a problem with those aged between 24 and 35 months being most affected. Wasting did not affect large population of the target group. Better educated household members had less malnourished kids (3%) than those who did not attend school (12%). Co-morbidities occurrence was significantly higher in malnourished children (P = 0.006). Acute Respiratory Tract Infection had the highest occurrence (52%). The children reported to have been sick had significantly lower weight than those who were normal (P<0.05). Food intake (mean dietary diversity of 25%) was not adequate for most households and only few people took protein of high quality like meat and milk. Household food practices were tested at 95% confidence interval and this affected the nutrition status of children (P = 0.02). In households with mean dietary diversity above four food groups, only 2.17 % of children were underweight as compared to 18.18% those from households with mean dietary diversity below three. Thus, interventions to eliminate malnutrition should focus on household food diversification and disease prevention.Key words: Prevalence, malnutrition, diseases, 24hr recall

Accessibility, availability and consumption of baobab during food emergencies in Kitui and Kilifi counties in Kenya

Baobab (Adansonia digitata L.) is an indigenous fruit tree (IFT) that grows in several dry parts of Kenya such as Kitui and Kilifi counties.  It plays a key role in dietary diversification thus contributing to food and nutrition security. This tree is adaptable to adverse climatic conditions such as droughts and floods, which are common in these counties. Consequently, it acts as a source of income and a food  buffer during disasters. This study evaluated the role baobab plays during food emergencies. The study employed a cross-sectional design where 216 household heads were interviewed through structured interviews. Data were analysed using SPSS version 24. Baobab was available during lean seasons and was used as a source of food and income. Respondents mainly consumed baobab fresh fruits without any processing (94%). During times of scarcity when there was nothing else available to eat. About 33.3% used baobab pulp to make porridge while 16.7% made a hard gruel (ugali). Drinks and candies, commonly called ‘mabuyu sweets’, accounted for 41.2% and 28.7%, respectively. In Kilifi, baobab pulp was mixed with coconut milk to be used as an accompaniment to ugali (34.3 %). About two thirds (60.7%) of the respondents collected and stored whole baobab fruits for use during lean seasons. Baobab pulp was sold by 34.7% of the respondents and the income was used to buy food (45.3 %), education (22.7%) and for healthcare (13. 3%). This study indicatesthat baobab fruit and pulp was available and accessible during lean seasons. The baobab pulp was mainly consumed without any processing as a snack. It also used to make different foods at times when many other foods were not available. Households sold baobab fruits to augment their income. Promotion of baobab products could bring better incomes and improve the nutritional status of communities in baobab growing areas and helps to overcome food insecurity in emergencies. Key words: lean seasons, baobab products, income, food insecurity, copin

Status of aflatoxin contamination in cow milk produced in smallholder dairy farms in urban and peri-urban areas of Nairobi County: A case study of Kasarani sub county, Kenya

Introduction: Milk consumption in Kenya supersedes other countries in East Africa. However, milk contamination with aflatoxin M1 (AFM1) is common, but the magnitude of this exposure and the health risks are poorly understood and need to be monitored routinely. This study aimed at assessing the awareness, knowledge and practices of urban and peri-urban farmers about aflatoxins and determining the levels of aflatoxin contamination in on-farm milk in a selected area within Nairobi County. Materials and methods: A cross-sectional study was undertaken to assess aflatoxin contamination levels of milk in Kasarani sub-county. A total of 84 milk samples were collected from small-holder dairy farms and analyzed for AFM1 using Enzyme-Linked Immunosorbent Assay (ELISA). Results and Discussion: Ninety nine percent of the samples (83/84) analysed were contaminated with AFM1. The mean aflatoxin level was 84 ng/kg with 64% of the samples exceeding the EU legal limit of 50 ng/kg. Whereas 80% of the farmers were aware of aflatoxin, there was no correlation between farmers’ knowledge and gender with AFM1 prevalence. Conclusion: This study concludes that AFM1 is a frequent contaminant in milk and there is need to enhance farmers awareness on mitigation

Foliar diseases and the associated fungi in rice cultivated in Kenya

We conducted a survey to assess the occurrence and severity of rice blast and brown spot diseases on popular cultivars grown in the Busia, Kirinyaga, and Kisumu counties of Kenya in 2019. Working with agricultural extension workers within rice production areas, we interviewed farmers (n = 89) regarding their preferred cultivars and their awareness of blast disease, as this was the major focus of our research. We scored the symptoms of blast and brown spot and assessed the lodging, plant height, and maturity of the crops (days after planting). Furthermore, we collected leaf and neck tissues for the assessment of the prevailing fungal populations. We used specific DNA primers to screen for the prevalence of the causal pathogens of blast, Magnaporthe oryzae, and brown spot, Cochliobolus miyabeanus, on asymptomatic and symptomatic leaf samples. We also conducted fungal isolations and PCR-sequencing to identify the fungal species in these tissues. Busia and Kisumu had a higher diversity of cultivars compared to Kirinyaga. The aromatic Pishori (NIBAM 11) was preferred and widely grown for commercial purposes in Kirinyaga, where 86% of Kenyan rice is produced. NIBAM108 (IR2793-80-1) and BW196 (NIBAM 109) were moderately resistant to blast, while NIBAM110 (ITA310) and Vietnam were susceptible. All the cultivars were susceptible to brown spot except for KEH10005 (Arize Tej Gold), a commercial hybrid cultivar. We also identified diverse pathogenic and non-pathogenic fungi, with a high incidence of Nigrospora oryzae, in the rice fields of Kirinyaga. There was a marginal correlation between disease severity/incidence and the occurrence of causal pathogens. This study provides evidence of the need to strengthen pathogen surveillance through retraining agricultural extension agents and to breed for blast and brown spot resistance in popular rice cultivars in Kenya