Microbiological evaluation and shelf life of seed flour mixes used for infant feeding in rural northern Nigeria

This study investigates microbial load and shelf life of locally processed cereal-legume-oil seed flour mixes used for infant feeding in rural northern Nigeria. Free fatty acid (FFA), water activity (aw), pH, total viable count (TVC) and presence of yeast, coliform bacteria and mold were the parameters determined. Hungry rice or Digitaria exilis, benne seed or Sesamum indicum and soybean or Glycine max seeds flours were produced using traditional processing methods, including washing, boiling, fermenting and roasting. The test samples were milled into flour that could pass through a 70 mm mesh sieve and blended on protein basis at 70:30 cereal-legume/oilseed ratios to produce D70S30, D70G30, D70S15G15, D70S20G10 and D70S10G20 and stored at 30 to 32°C for 60 days. The parameters were determined at day 0 and intervals of 14, 28, 42 and 60 days. At the end of the storage period, all the parameters increased. FFA increased from 0.15 - 0.16% to 0.47 - 0.58%; aw from 0.46 - 0.48 to 0.72 - 0.80; pH from 3.9 to 4.7 - 4.9 and TVC from <1.0x102 to 2.2x103 to 3.6×104cfu/g for 0 and 60 days, respectively. The differences between the values of the parameters of the formulations were significant (p<0.05) especially from day 14. Yeast and coliform were not detected in all the samples but mold was detected from days 14 to 60. The formulation D70S30 had best shelf life; however, the samples should be consumed within 14 days of production.Key words: Seed flour, multi-mixes, children, microbial load, shelf life

Evaluation of a social marketing intervention promoting oral rehydration salts in Burundi

<p>Abstract</p> <p>Background</p> <p>Diarrhea is the second leading cause of death for children under five in Burundi; however, use of oral rehydration salts (ORS), the recommended first-line treatment, remains low. In 2004, PSI/Burundi launched a social marketing intervention to promote ORASEL among caregivers of children under five; the product was relaunched in 2006 with a new flavor. This study evaluates the intervention after the ORASEL relaunch, which included mass media and interpersonal communication activities. The study looks at trends in ORASEL use in Burundi and in behavioral determinants that may be related to its use.</p> <p>Methods</p> <p>In 2006 and 2007, PSI conducted household surveys among Burundian females of reproductive age (15-49). Both surveys used a two-stage sampling process to select 30 households in each of 115 rural and urban collines throughout the nation. Survey respondents were asked about diarrhea treatment-related behavior; key behavioral determinants; and exposure to the ORASEL intervention. Data were analyzed to identify trends over time, characteristics of ORASEL users, and associations between exposure to the intervention and changes in ORASEL use and related behavioral determinants.</p> <p>Results</p> <p>ORASEL use among caregivers at their children's last diarrheal episode increased significantly from 20% in 2006 to 30% in 2007, and there were also desirable changes in several behavioral determinants associated with ORASEL use. Evaluation analysis showed that a higher level of exposure to the social marketing campaign was associated with greater use of ORASEL and with significant improvements in perceived availability, knowledge of the signs of diarrhea and dehydration, social support, and self-efficacy.</p> <p>Conclusions</p> <p>ORS use can be improved through social marketing and educational campaigns that make the public aware of the availability of the product, encourage dialogue about its use, and increase skills and confidence relating to correct product preparation and administration. Further interventions in Burundi and elsewhere should promote ORS through a variety of mass media and interpersonal communication channels, and should be rigorously evaluated in the context of the total market for diarrhea treatment products.</p

The Recognition of and Care Seeking Behaviour for Childhood Illness in Developing Countries: A Systematic Review

Background: Pneumonia, diarrhoea, and malaria are among the leading causes of death in children. These deaths are largely preventable if appropriate care is sought early. This review aimed to determine the percentage of caregivers in low- and middle-income countries (LMICs) with a child less than 5 years who were able to recognise illness in their child and subsequently sought care from different types of healthcare providers. Methods and Findings: We conducted a systematic literature review of studies that reported recognition of, and/or care seeking for episodes of diarrhoea, pneumonia or malaria in LMICs. The review is registered with PROSPERO (registration number: CRD42011001654). Ninety-one studies met the inclusion criteria. Eighteen studies reported data on caregiver recognition of disease and seventy-seven studies on care seeking. The median sensitivity of recognition of diarrhoea, malaria and pneumonia was low (36.0%, 37.4%, and 45.8%, respectively). A median of 73.0% of caregivers sought care outside the home. Care seeking from community health workers (median: 5.4% for diarrhoea, 4.2% for pneumonia, and 1.3% for malaria) and the use of oral rehydration therapy (median: 34%) was low. Conclusions: Given the importance of this topic to child survival programmes there are few published studies. Recognition of diarrhoea, malaria and pneumonia by caregivers is generally poor and represents a key factor to address in attempts to improve health care utilisation. In addition, considering that oral rehydration therapy has been widely recommended for over forty years, its use remains disappointingly low. Similarly, the reported levels of care seeking from community health workers in the included studies are low even though global action plans to address these illnesses promote community case management. Giving greater priority to research on care seeking could provide crucial evidence to inform child mortality programmes

Dietary Habits and Nutritional Status of Rural School Age Children in Ebonyi State, Nigeria

Objectives: To determine the dietary habits and nutritional status of rural school age children in Ebonyi State, Nigeria. Materials and Methods: A total of 360 school children aged 5 – 14 years (194 males and 166 females) were selected through a multi stage random sampling procedure. Structured interviewer-administered questionnaire was used to obtain information on children’s family characteristics, parents’ socio-economic characteristics; and their dietary habits. The heights and weights of the children were measured using approved methods. Age was accessed using documentary evidences provided by parents. The WHO reference body mass index (BMI)-for-age was used to classify the children. Data obtain were analyzed using descriptive statistics and chi-square analysis. Results: The children were from predominantly farming communities and consumed highly monotonous diets. 24-hour dietary recall showed that majority of the respondents ate cassava-baseddiets for breakfast and dinner quite often. Less than 2.0% of the respondents consumed chicken, egg and meat. Although most of the children reported that they consumed fruits, 24hour dietary recall showed tha

Composition, Acceptability and Efficacy of Fermented and Unfermented Cereal-based Oral Rehydration Solution for Home Management of Diarrhoea in Children

Objective: The main objective was to evaluate the efficacy of fermented and unfermented cereal-based-Oral Rehydration Solution (CB-ORS) for home management of diarrhoea in children. Materials and Methods: Local varieties of white maize (Zea mays) and rice (Oritz sativa) fermented (48h) and unfermented were processed into fine flours. The proximate composition of the flours was determined using approved methods. CB-ORS were prepared using 50g of cereal flour dissolved in 1000ml of water with salt added. Fifty children (6-60 months) admitted in two hospitals in Onitsha, Anambra State, Nigeria, diagnosed for mild to moderate dehydration were recruited and randomly assigned to one of the five treatment groups: four test CB-ORS and a control (UNICEF-ORS&ge;310mOsm/L). Sixty millilitres (60ml) of the ORS were given every 30 minutes or after every vomiting/stooling. Body weights, packed cells volume (PCV) were measured before and after oral re-hydration therapy (ORT). Stool frequency and consistency were determined after commencing ORT. Clinical signs of rehydration were evaluated using approved methods. Structured, pre-tested and validated questionnaire was used to assess mothers&rsquo; perception of the CB-ORS. Result: More of the UNICEF-ORS was consumed than the CB-ORS. CB-ORS were more nutrient dense. After 6h of ORT, 90% of subjects given UNICEF-ORS were fully rehydrated compared to 80% and 70% of those given unfermented maize and fermented rice ORS, respectively. Within 2 days, 100% and 90% of those given the unfermented and fermented rice-based ORS had formed stools compare to 80% and 60% of those given the unfermented and fermented maize-based ORS, respectively. None of the subjects given the control had formed stools before the 4th day. There were also significant (p=&lt;0.05) changes in PCV values of subjects given the fermented rice and unfermented maize ORS. About 98% of the children accepted the CB-ORS and 95% of the mothers were willing to use them again. Conclusion: UNICEF-ORS (whether old or new) remains the best option for rehydrating the diarrhoea child; however, cereal-based ORS (fermented or unfermented) could be used for both preventing dehydration as well as speeding stool formation. Fermented rice and unfermented maize based-ORS could be used as effective alternatives for home management of diarrhoea in children, especially in resource poor environments.Key words: composition, acceptability, efficacy, fermented, unfermented, rice, maize, oral rehydration solution, acute diarrhoea

Effect of Mother's Characteristics and Infant Feeding Practices on the Nutritional Status of Children (0-2 years) in a Rural Community in Enugu State, Nigeria

Objective: This study was aimed at determining the effect of mother's characteristics and infant feeding practices on the anthropometric status of children (0-2 years). Subjects and Methods: A cross-sectional survey was carried out in a rural community in Enugu State. Information on mother's characteristics and infant feeding practices was obtained using validated, pretested questionnaire, while anthropometric status of the children were obtained by measuring their weights and heights using standard methods. Height-for-age (stunting), weight-for-height (wasting) and weightfor-age (under nutrition) indices were calculated from the raw data. The relationship between these indices and mother's characteristics was evaluated using Chi-square analysis Result: The results showed that 28% of the children were stunted, 20% were malnourished and 30.8% were wasted. Up to 74.4% of mothers with children 0-6 months of age exclusively breastfed their infants. Few mothers (7.5%) gave breast milk to their babies immediately after birth, while 28.3% gave breast milk 24 hours after birth. The major reason for giving breast milk 24 hours after birth was because breast milk had not started flowing (70.6%).Water was mostly used to sustain the babies within the first 24 hours after birth (46.4%). It was found that none of the exclusively breastfed babies were stunted, malnourished or wasted. Mothers who earned higher income had less stunted malnourished and wasted infants than those who earned lower income. Education and occupation affected the nutritional status of these infants negatively. Conclusion: The study has shown that exclusive breastfeeding remains the best for the infant. It also showed that mother's care giving behaviour was a strong determinant of the nutritional status of the children. Key words: Infant feeding practices, mother characteristics, nutritional status, rural Nigeria