Nutrient Intake among Pregnant Teenage Girls Attending Ante-Natal Clinics in Two Health Facilities in Bungoma South District, Western Kenya

Objective: To assess the adequacy of nutrient intake including proteins, energy, calcium, iron, folate and vitamin C and identify the factors associated with nutrient intake.Design: Cross sectional study.Setting: Healthy facility based. Bungoma District Hospital and Bumula Health centre.Subjects: Teenage pregnant girls attending Antenatal Clinic participated after providing written consent, with girls under 18 years being considered as emancipated minors. A standardised interviewer administered Food Frequency Questionnaire was used to asses the dietary intake. Nutrient calculator was used to determine the nutrient intake of the study participant.Results: The intakes of all selected nutrients were significantly lower than the RDA. Protein intake was significantly associated with Education (OR: 0.537; 95% CI: 0.318 – 0.907), income (OR: 0.049; 95% CI: 0.919 – 0.128) and perceived food shortage (OR: 0.617; 95% CI: 0.389 – 0.890). Energy intake was significantly associated with income (p=0.007, OR: 2.103; 95%CI: 1.225 – 3.608). Iron intake was significantly associated with perceived food shortage (OR: 2.548; 95% CI: 1.632 – 3.980). Hookworm affected calcium intake (OR: 3.074; 95% CI: 1.089 – 8.698) and malaria parasites affected folate intake (OR: 0.355; 95% CI: 0.226 – 0.557). Those with hookworm were 3 times more likely to have inadequate calcium intake as compared to those without.Conclusion: All the nutrients selected were lower than the Required Dietary Allowance. Level of education, income, Hookworm and malaria affected intake of various nutrients

Lipid-soluble Vitamins A, D, and E in HIV-Infected Pregnant women in Tanzania.

There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01). Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions

Vitamin A, vitamin E, iron and zinc status in a cohort of HIV-infected mothers and their uninfected infants

Introduction We hypothesized that nutritional deficiency would be common in a cohort of postpartum, human immunodeficiency virus (HIV)-infected women and their infants. Methods Weight and height, as well as blood concentrations of retinol, α-tocopherol, ferritin, hemoglobin, and zinc, were measured in mothers after delivery and in their infants at birth and at 6-12 weeks and six months of age. Retinol and α-tocopherol levels were quantified by high performance liquid chromatography, and zinc levels were measured by atomic absorption spectrophotometry. The maternal body mass index during pregnancy was adjusted for gestational age (adjBMI). Results Among the 97 women 19.6% were underweight. Laboratory abnormalities were most frequently observed for the hemoglobin (46.4%), zinc (41.1%), retinol (12.5%) and ferritin (6.5%) levels. Five percent of the women had mean corpuscular hemoglobin concentrations < 31g/dL. The most common deficiency in the infants was α-tocopherol (81%) at birth; however, only 18.5% of infants had deficient levels at six months of age. Large percentages of infants had zinc (36.8%) and retinol (29.5%) deficiencies at birth; however, these percentages decreased to 17.5% and 18.5%, respectively, by six months of age. No associations between infant micronutrient deficiencies and either the maternal adjBMI category or maternal micronutrient deficiencies were found. Conclusions Micronutrient deficiencies were common in HIV-infected women and their infants. Micronutrient deficiencies were less prevalent in the infants at six months of age. Neither underweight women nor their infants at birth were at increased risk for micronutrient deficiencies

Undernutrition of orphans and vulnerable children: a comparison of cash transfer beneficiaries and non beneficiaries in korogocho slums, Nairobi

Objective: To assess the prevalence and associated factors for undernutrition among the beneficiaries of Kenya Cash Transfer Program compared to non-beneficiaries in Korogocho, Nairobi. Optimal nutrition reduces the prevalence of undernutrition and contributes to improved child survival and development.Methods: A comparative descriptive cross-sectional study design in which a total of 336 children were sampled from the two groups each consisting 168 children. A questionnaire was administered to caregivers. A Food Frequency Questionnaire and a 24 Hour Recall sought information on foods consumed. Anthropometric measurements were taken based on standard procedures. Wasting, underweight and stunting were determined based on a z-score of ≥-2 or &lt;-2 SD. A chi-square test was used to test significance associations of wasting, underweight and stunting with other variables.Results: A majority (89.3%) and (73.8%) of the principal caregivers were females among the beneficiaries and non-beneficiaries respectively. Among the beneficiaries, prevalence of wasting was 6%, underweight 6% and stunting 32.7%. Among non-beneficiaries, undernutrition was higher with wasting 9.5%, underweight 17.9% and stunting 37.5%. There was a significant difference (х2=11.351, df=1, p=0.001) for underweight among the beneficiaries and non-beneficiaries. Nutrient inadequacies were high in vitamin A, folate and zinc in both beneficiaries and non-beneficiaries. In beneficiaries, undernutrition was significantly (p&lt;0.05) associated with number of children aged 6-59 months in the household, cash transfer used on food, carbohydrate intake, protein intake and frequency of breastfeeding. Among non-beneficiaries, undernutrition was significantly (p&lt;0.05) associated with number of household members, number of children 6-59 months in the household and income spent on food.Conclusions: There was improved nutritional status among the beneficiaries compared to non-beneficiaries. However, there is need of training beneficiaries on the best use of the cash transfers and educating them on consumption of adequate food to improve nutrient intake and eventually their nutritional status.Key words: Undernutrition, Orphans, Vulnerable, Beneficiaries, Non-beneficiarie