Central obesity and diet quality in rural farming women of Ngamiland, Botswana

Rapid economic growth in Botswana like in other countries has led to the emergence of nutrition transition. Overweight/obesity, central adiposity and associated co-morbidities are on the rise, especially amongst women. Urban women have been shown to be more prone to overweight/obesity compared to men. However, the situation in rural women has not been studied. Therefore, this paper assesses the prevalence of central obesity in rural female farmers (N=113) of Ngamiland, Botswana over two years. Estimation of central obesity was made through assessment of waist circumference (WC) and waist hip ratios (WHR). The WHO Indicator cut-off points (WC: low risk= <80 cm; increased= 80-87.9 cm; and substantially increased= >88 cm and WHR: low risk= ≤0.85 and high risk=0.85+) for risk of metabolic complication were used to categorize women according to body fatness levels. A non-quantified dietary diversity questionnaire was also administered to individuals with responsibility over food, to assess the participant’s dietary diversity. Women were assigned dietary diversity scores (DDS) ranging from 0 to 8, depending on the number of food groups represented in their diet in the past 24 hours. The higher the number the more diversified the diet. These measurements were collected in August 2010 and September 2011. Between 2010 and 2011 the mean WC increased from 87±11.8 to 90.2±14.5 while the WHRs in 2010 increased from 0.83±0.1 to 0.86±0.1 respectively. Diets comprised mostly of starchy foods, milk and miscellaneous foods such as fats/oils, sugars, and condiments. Mean DDS for both periods was 3 showing poor quality diet and little change over the two years. Central adiposity was observed amongst the women as shown by a significant increase in WC between 2010 and 2011 (t=2.818, df=112, p=0.006). Contrary to expectations that rural female farmers in Ngamiland Botswana would be healthy compared to their non-farming counterparts, there seems to be an observable similar trend of overweight. Furthermore, quality of traditional diets seems to be deteriorating with less consumption of healthy protective and nutrient dense foods, which are likely to influence a rise in metabolic complications. The authors therefore recommend strategies that will facilitate reduction of waist sizes to 80.0 cm such as farming and consumption of healthier foods such as fruits and vegetables along with the commonly produced ones in the fields. Farming communities should also value and include traditional and wild foods in their diets to increase dietary diversity and reduce the risk of development of chronic diseases.Keywords: Central obesity, Rural Female Farmers, Overweight, Obesity, Ngamiland, Botswan

Distribution of schistosomiasis and soil transmitted Helminthiasis in Zimbabwe:Towards a national plan of action for control and elimination

Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009-2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted.A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques.Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%-18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened.This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe

Impact of Schistosome Infection on Plasmodium falciparum Malariometric Indices and Immune Correlates in School Age Children in Burma Valley, Zimbabwe

A group of children aged 6–17 years was recruited and followed up for 12 months to study the impact of schistosome infection on malaria parasite prevalence, density, distribution and anemia. Levels of cytokines, malaria specific antibodies in plasma and parasite growth inhibition capacities were assessed. Baseline results suggested an increased prevalence of malaria parasites in children co-infected with schistosomiasis (31%) compared to children infected with malaria only (25%) (p = 0.064). Moreover, children co-infected with schistosomes and malaria had higher sexual stage geometric mean malaria parasite density (189 gametocytes/µl) than children infected with malaria only (73/µl gametocytes) (p = 0.043). In addition, a larger percentage of co-infected children (57%) had gametocytes as observed by microscopy compared to the malaria only infected children (36%) (p = 0.06). There was no difference between the two groups in terms of the prevalence of anemia, which was approximately 64% in both groups (p = 0.9). Plasma from malaria-infected children exhibited higher malaria antibody activity compared to the controls (p = 0.001) but was not different between malaria and schistosome plus malaria infected groups (p = 0.44) and malaria parasite growth inhibition activity at baseline was higher in the malaria-only infected group of children than in the co-infected group though not reaching statistical significance (p = 0.5). Higher prevalence and higher mean gametocyte density in the peripheral blood may have implications in malaria transmission dynamics during co-infection with helminths

The human resource implications of improving financial risk protection for mothers and newborns in Zimbabwe

Peer reviewedPublisher PD

Malaria incidence trends and their association with climatic variables in rural Gwanda, Zimbabwe, 2005-2015

Background Malaria is a public health problem in Zimbabwe. Although many studies have indicated that climate change may influence the distribution of malaria, there is paucity of information on its trends and association with climatic variables in Zimbabwe. To address this shortfall, the trends of malaria incidence and its interaction with climatic variables in rural Gwanda, Zimbabwe for the period January 2005 to April 2015 was assessed. Methods Retrospective data analysis of reported cases of malaria in three selected Gwanda district rural wards (Buvuma, Ntalale and Selonga) was carried out. Data on malaria cases was collected from the district health information system and ward clinics while data on precipitation and temperature were obtained from the climate hazards group infrared precipitation with station data (CHIRPS) database and the moderate resolution imaging spectro-radiometer (MODIS) satellite data, respectively. Distributed lag non-linear models (DLNLM) were used to determine the temporal lagged association between monthly malaria incidence and monthly climatic variables. Results There were 246 confirmed malaria cases in the three wards with a mean incidence of 0.16/1000 population/month. The majority of malaria cases (95%) occurred in the > 5 years age category. The results showed no correlation between trends of clinical malaria (unconfirmed) and confirmed malaria cases in all the three study wards. There was a significant association between malaria incidence and the climatic variables in Buvuma and Selonga wards at specific lag periods. In Ntalale ward, only precipitation (1- and 3-month lag) and mean temperature (1- and 2-month lag) were significantly associated with incidence at specific lag periods (p < 0.05). DLNM results suggest a key risk period in current month, based on key climatic conditions in the 1–4 month period prior. Conclusions As the period of high malaria risk is associated with precipitation and temperature at 1–4 month prior in a seasonal cycle, intensifying malaria control activities over this period will likely contribute to lowering the seasonal malaria incidence