Accuracy of maternal recall of birth weight and selected delivery complications in Zanzibar

Background: Birth weight is one of the key predictor for survival, health and future development of a child. In developing countries data on birth weights are limited to obtain due to difficulties in keeping records especially among rural women. Maternal recall of birth weight can therefore become a useful source of birth weight data. This study was carried out to determine recall of birth weight and delivery complications among mothers in Unguja West District of Zanzibar.Methods: This cross-sectional study involve mothers who had children below five years of age. Pretested structured questionnaire was used to collect information on socio-demographic characteristics of the mother, age of the child, birth weight of the child and delivery complications. Other information was obtained from maternal antenatal clinic and child’s growth monitoring cards. Results: A total of 260 women were included in the study. The mean age of the mothers was 29 years, ranging from 17 to 45 years. More than half (62%) had attained secondary education and few had informal education (6.5%) or post-secondary education (12%). Majority of the mothers (85%) delivered at the health facility assisted by trained health care provider. Those who delivered at home (15%) were either assisted by a relative or Traditional Birth Attendant (TBA). Over three quarters (78.5%) of the mothers had birth weights of their children recorded in the postnatal care cards. Out of 38 children who were born at home, 87% (n = 33) were not weighed and there were 23 women (10.4%) who delivered at the hospital but their children’s weight were not recorded. Overall, 46 (20%) mothers could not correctly recall birth weights of their children where. There was strong correlation between recall and recorded birth weight (r2=0.79; p<0.01). Reported/recorded delivery complications were hypertension, excessive bleeding, low birth weight, episiotomy, anaemia and preeclampsia.Conclusion: Maternal recall can provide reliable information with regard to child’s birth weight and delivery complications. Health facility staff should measure child’s weight correctly, inform the mother and record in the child’s card in order to facilitate correct recall by the mothers

Effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth of infants and young children in rural Tanzania : rationale, design and methods of a cluster randomised trial

Background: Strategies to improve infant and young child nutrition in low and middle-income countries need to be implemented at scale. We contextualised and packaged successful strategies into a feasible intervention for implementation in rural Tanzania. Opportunities that can optimise delivery of the intervention and encourage behaviour change include mothers willingness to modifying practices; support of family members; seasonal availability and accessibility of foods; established set-up of village peers and functioning health system. The primary objective of the study is to evaluate the effectiveness of a nutrition education package in improving feeding practices, dietary adequacy and growth as compared to routine health education. Methods/Design: A parallel cluster randomised controlled trial will be conducted in rural central Tanzania in 9 intervention and 9 control villages. The control group will receive routine health education offered monthly by health staff at health facilities. The intervention group will receive a nutrition education package in addition to the routine health education. The education package is comprised of four components: 1) education and counselling of mothers, 2) training community-based nutrition counsellors and monthly home visits, 3) sensitisation meetings with health staff and family members, and 4) supervision of community-based nutrition counsellors. The duration of the intervention is 9 months and infants will be recruited at 6 months of age. Primary outcome (linear growth as length-for-age Z-scores) and secondary outcomes (changes in weight-for-length Z-scores; mean intake of energy, fat, iron and zinc from complementary foods; proportion of children consuming 4 or more food groups and recommended number of semi-solid/soft meals and snacks per day; maternal level of knowledge and performance of recommended practices) will be assessed at baseline and ages 9, 12 and 15 months. Process evaluation will document reach, dose and fidelity of the intervention and context at 8 and 15 months. Discussion: Results of the trial will provide evidence of the effectiveness of the nutrition education package in community settings of rural Tanzania. They will provide recommendations for strengthening the nutrition component of health education in child health services

Feeding Practices and Factors Contributing to Wasting, Stunting, and Iron-deficiency Anaemia Among 3-23-month Old Children in Kilosa District, Rural Tanzania

Infants in Tanzania are particularly vulnerable to under-nutrition during transition from breastmilk (as the only source of nourishment) to solid foods. A cross-sectional study was undertaken in Kilosa district in Tanzania to determine the feeding practices and the extent of wasting, stunting, and iron-deficiency anaemia. The study was done in two stages: in the first stage, a 24-hour dietary assessment was conducted to identify the type of complementary foods given and the eating habits according to age for 378 children aged 3-23 months. In the second stage, a progressive recruitment of 309 infants aged six months was made to measure weight, length, haemoglobin (Hb) concentration, zinc protoporphyrin concentration, and malaria parasitaemia. Birth-weight, the potential contributing factor to under-nutrition and iron-deficiency anaemia, was obtained from the children's clinic cards. The 24-hour dietary assessment revealed that children consumed mainly a thin porridge prepared from maize flour as complementary food. Carbohydrates contributed most energy (on average 69%), followed by fats (18.6%) and protein (on average 12.1%). The complementary food covered only 15%, 20%, and 27% of the recommended iron intake for children aged 6-8, 9-11 and 12-23 months respectively. The mean Hb concentration was 9.3\ub11.9 g/dL, 68% of the infants were moderately anaemic(7-<11 g/dL), and about 11% were severely anaemic with Hb below 7 g/dL, while 21% were non-anaemic Hb ( 6511 g/dL). Equally, the mean zinc protoporphyrin concentration was 10.0\ub16.2 \u3bcg/g Hb, and 76% of the infants were iron-deficient(>5 \u3bcg/g Hb). The prevalence of stunting was 35%, while wasting was only 1.3%. Low birth-weight and low body mass index of mothers were the strong predictors of stunting, whereas low birth-weight and iron-deficiency were the strong predictors of anaemia. The prevalence of malaria parasitaemia was high, affecting 50% of the infants. Having malaria was the only independent predictor associated with stunting, anaemia, and iron-deficiency. There is an urgent need to improve traditional complementary foods in the studied community in terms of energy density, amount of fat in the diet, and bioavailability of macro and micronutrients

Infant and young child feeding practices on Unguja Island in Zanzibar, Tanzania: a ProPAN based analysis

Background: Undernutrition in children has remained a challenge despite the success achieved in reduction of other childhood diseases in Zanzibar. Most empirical studies on infants and young child feeding (IYCF) have examined nutritional value of foods fed to the children in terms of energy and micronutrient content. Little is known on the role of culture, traditions and social norms in influencing IYCF practices. This study aimed at assessing the existing IYCF practices and socio-cultural factors influencing these practises using ProPAN tool to get an in-depth understanding of the mothers’ practices with respect to exclusive breastfeeding and infant and young child feeding.Methods: A cross sectional study involving mothers/caregivers was conducted using semi-structured interviews and opportunistic observations on Unguja Island, Zanzibar. A random selection of 36 Shehias and 213 households with children 0 – 23 months old was done proportional-to-size of Shehias and children. Quantitative and qualitative data were collected using the ProPAN tool and embedded software for analyses.Results: A total of 213 of mothers/caregivers were involved in the study. Almost all new-borns were fed colostrum (96%). Proportion of mothers who   initiated breastfeeding within one hour after giving birth was 63%. About 24% of the women practiced exclusive breastfeeding and 21% of the children were given pre-lacteal feeds 2-3 days after birth. The mean age of introduction of complementary foods was four months. Responsive feeding was not practiced by some mothers as 31% of the children 12-23 months of age were left to eat alone without any support from caregivers. The common reasons for non-adherence to the recommended feeding practices were related to income and socio-cultural norms which are strong in the community and supported by other family members.Conclusion: Infant and young child feeding in Unguja was suboptimal. Inadequate care practices, use of pre-lacteals, early introduction of complementary foods, low rate of exclusive breastfeeding and low meal frequency were among the common practices. The main causes of the observed feeding practice were related to socio-cultural norms and beliefs. There is a need to strengthen IYCF education into the antenatal clinic regime

Oyster mushroom (Pleurotus spp.) cultivation technique using re-usable substrate containers and comparison of mineral contents with common leafy vegetables

Mamiro et al. J. Appl. Biosci. 2014. Oyster mushroom (Pleurotus spp.) Cultivation technique using reusable substrate containers and comparison of mineral content with leafy vegetables.Alternative re-usable substrate containers for fructification are required because plastic bags currently used suffocate soil biotic entities. They are a cost for mushroom farmers who purchase plastic bags in every oyster mushroom crop and they are left as non-biodegradable wastes, which are disposed of to the environment after every oyster mushroom cropping. On the other hand, oyster mushroom contains essential nutritional elements comparable to leafy vegetables. Objectives: The objectives of this study were to determine the effects of substrate types and substrate containers on yield, biological efficiency, size and solid content of oyster mushroom Pleurotus ostreatus; and to compare mineral content of mushrooms produced from different types of substrates to common leafy vegetables. Methodology and results: Substrate containers: clear plastic bags, re-usable substrate containers (RSC), coloured plastic bags, shelved clear plastic bags and substrates: banana leaves, rice straws and maize cobs were used to grow oyster mushrooms. The experiment was carried out in complete randomized block design (CRBD) in a factorial arrangement. The mineral content of oyster mushroom grown on rice straws, Leucaena leucocophala, sorghum grains, banana leaves and maize cobs substrates were compared in a CRBD to those of pumpkin leaves (Curcubita spp.), narrow-leaved African night shade (Solanum villosum), broad-leaved African night shade (Solanum scabrum), cowpea leaves (Vigna unguiculata), cabbage (Brassica spp.), sweet potato leaves (Ipomea batatas), amaranth (Amaranthus spp.) and cassava leaves (Manihot esculentus L.). Mushroom yields and BE in RSC were comparable to non-RSC. The highest yields (1,116.25 g/g) and BE (105.75%) were produced from rice straws substrate in coloured bags followed by RSC (yield 694.6 g/g, BE 65.6%). Mushroom solids content (19.4%) was highest from banana leaves substrates. The highest Fe, Zn, Se and Ca were obtained from amaranth, oyster mushrooms produced from rice straws, narrow- and broad-leaves African nightshade and pumpkin leaves respectively. Conclusion and application of results: The utilization of RSC to produce oyster mushrooms protects the environment from disposed plastic bags which are non-biodegradable and if burned may cause ill-health effect to the human. Additional research is needed to specify quality of material to be used in the manufacture of RSC and specifications to suit cultivation of oyster mushrooms. In addition, consumption of oyster mushrooms in combination with other vegetables complements availability of various essential dietary elements such as Fe, Zn, Se and Ca

Oyster mushroom (Pleurotus spp.) cultivation technique using re-usable substrate containers and comparison of mineral contents with common leafy vegetables

Mamiro et al. J. Appl. Biosci. 2014. Oyster mushroom (Pleurotus spp.) Cultivation technique using reusable substrate containers and comparison of mineral content with leafy vegetables.Alternative re-usable substrate containers for fructification are required because plastic bags currently used suffocate soil biotic entities. They are a cost for mushroom farmers who purchase plastic bags in every oyster mushroom crop and they are left as non-biodegradable wastes, which are disposed of to the environment after every oyster mushroom cropping. On the other hand, oyster mushroom contains essential nutritional elements comparable to leafy vegetables. Objectives: The objectives of this study were to determine the effects of substrate types and substrate containers on yield, biological efficiency, size and solid content of oyster mushroom Pleurotus ostreatus; and to compare mineral content of mushrooms produced from different types of substrates to common leafy vegetables. Methodology and results: Substrate containers: clear plastic bags, re-usable substrate containers (RSC), coloured plastic bags, shelved clear plastic bags and substrates: banana leaves, rice straws and maize cobs were used to grow oyster mushrooms. The experiment was carried out in complete randomized block design (CRBD) in a factorial arrangement. The mineral content of oyster mushroom grown on rice straws, Leucaena leucocophala, sorghum grains, banana leaves and maize cobs substrates were compared in a CRBD to those of pumpkin leaves (Curcubita spp.), narrow-leaved African night shade (Solanum villosum), broad-leaved African night shade (Solanum scabrum), cowpea leaves (Vigna unguiculata), cabbage (Brassica spp.), sweet potato leaves (Ipomea batatas), amaranth (Amaranthus spp.) and cassava leaves (Manihot esculentus L.). Mushroom yields and BE in RSC were comparable to non-RSC. The highest yields (1,116.25 g/g) and BE (105.75%) were produced from rice straws substrate in coloured bags followed by RSC (yield 694.6 g/g, BE 65.6%). Mushroom solids content (19.4%) was highest from banana leaves substrates. The highest Fe, Zn, Se and Ca were obtained from amaranth, oyster mushrooms produced from rice straws, narrow- and broad-leaves African nightshade and pumpkin leaves respectively. Conclusion and application of results: The utilization of RSC to produce oyster mushrooms protects the environment from disposed plastic bags which are non-biodegradable and if burned may cause ill-health effect to the human. Additional research is needed to specify quality of material to be used in the manufacture of RSC and specifications to suit cultivation of oyster mushrooms. In addition, consumption of oyster mushrooms in combination with other vegetables complements availability of various essential dietary elements such as Fe, Zn, Se and Ca

Effect of germination and autoclaving of sprouted finger millet and kidney beans on cyanide content

Cyanide contents of locally purchased brown finger millet ( Eleusine corocana L. Gaertner) and brown speckled kidney bean seeds ( Phaseolus vulgaries var. Rose Coco ) were determined using raw, germinated and autoclaved samples. The aim was to establish the extent of cyanide content increase resulting from the germination process and the effectiveness of the autoclaving process on the reduction of cyanide levels in the samples, for safety considerations. Autoclaving was carried out at 121°C for 20 minutes. It was found that germination increased the cyanide content by 2.11 to 2.14 fold in finger millet for laboratory processed samples. In the case of kidney beans the increment was 1.76 to 1.77 fold for laboratory samples. The increments for field processed samples were in the same range as those for laboratory samples. Autoclaving reduced the cyanide content to between 61.8 and 65.9 % of the original raw contents for finger millet and between 56.6 to 57.8% in the case of kidney beans. The corresponding reductions for field samples were also found to be within the same ranges as the laboratory processed samples. It was concluded that autoclaving significantly reduced the cyanide levels in germinated finger millet and kidney beans

Feeding practices and nutrient content of complementary meals in rural central Tanzania: implications for dietary adequacy and nutritional status

Research Article published by Kulwa et al. BMC PediatricsBackground: Stunting and micronutrient deficiencies are significant health problems among infants and young children in rural Tanzania. Objective of the study was to assess feeding practices, nutrient content of complementary meals, and their implications for dietary adequacy and nutritional status. Methods: A cross-sectional study was conducted in six randomly selected villages in Mpwapwa District, Tanzania during the post-harvest season. Information on feeding practices, dietary consumption and anthropometric measurements of all infants below the age of one year were collected. Forty samples of common meals were collected and analysed for proximate composition, iron, zinc and calcium. Results were expressed per 100 g dry weight. Results: Energy, protein and fat content in porridge ranged from 40.67–63.92 kcal, 0.54–1.74 % and 0.30-2.12 %, respectively. Iron, zinc and calcium contents (mg/100 g) in porridge were 0.11–2.81, 0.10–3.23, and 25.43-125.55, respectively. Median portion sizes were small (porridge: 150–350 g; legumes and meats: 39–90 g). Very few children (6.67 %) consumed animal-source foods. Low meal frequency, low nutrient content, small portion size and limited variety reduced the contribution of meals to daily nutritional needs. Conclusions: Findings of the study highlight inadequate feeding practices, low nutritional quality of meals and high prevalence of stunting. Feasible strategies are needed to address the dietary inadequacies and chronic malnutrition of rural infants