Expecting too much from the rural development:a case of the Iringa nutrition project

\ud The Iringa Nutrition Project (INP) supported jointly by the Government of Tanzania and UNICEF was started in 1984 as one way to improve mral livelihood. It was implemented in Jringa region because it was found that despite good food supply in the region, there were still high rates of malnutrition among children. The present study was carried out in Thirty­ nine villages of Ludewa and Iringa districts to evaluate the performance of the INP. Child growth and nutrition status data for the period between 1984 and 1992 were used. Indicators of project outcome included success in lowering the proportion of malnourished children and extent of coverage (number of children reached). In addition, regression analysis was used in identifying the community characteristics that were responsible for determining rate of mal­ nutrition changes in the study area. It was observed that 10 percent of the 39 villages in the project area were able to maintain a downward trend in malnutrition during the period 1984-\ud 86 and 18 percent in 1987-92 period. None of the villages was able to sustain a continuous\ud downward trend for the entire period of nine years (1984 to 1992). The regression ana ysis revealed that malnutrition declined significantly in those wards where the rates of malnutri­ tion were highest at the outset of the project. In addition Dominant cropping system and population size indirectly affected the capability to improve nutrition through their influence on coverage. In conclusion, the lringa Nutrition Project appears to have had only a modest impact on improving the nutritional status of children in lringa. This implies that, while the use o_f projects to combat malnutrition in poor countries may still be inevitable, we should not expect too much from these projects.\u

Gestational diabetes mellitus in sub-Saharan Africa: systematic review and meta-regression on prevalence and risk factors

Objective We systematically reviewed publications on prevalence and risk factors for gestational diabetes mellitus (GDM) in the 47 countries of sub-Saharan Africa. Methods We conducted a systematic search in PUBMED and reviewed articles published until June 2014 and searched the references of retrieved articles. We explored sources of heterogeneity among prevalence proportions with meta-regression analysis. Results Of 1069 articles retrieved 22 studies were included. Half were from West Africa, specifically Nigeria, five from South Africa and six from East and Central Africa. There were differences in screening methods and diagnosis criteria used, even between studies done in the same country and same time period. Meta-regression analysis indicated high heterogeneity among the studies (I2 = 100, p 30 years. Conclusions There are few studies on prevalence and risk factors for GDM in Sub-Saharan Africa and heterogeneity is high. Prevalence was up to about 14% when high risk women were studied. Preventive actions should be taken to reduce the short and long term complications related to GDM in Sub-Saharan Africa

High blood pressure and associated risk factors among women attending antenatal clinics in Tanzania

Aim: Hypertension during pregnancy (HDP) is one of the leading causes of maternal and perinatal mortality worldwide. This study examined prevalence and potential risk factors for HDP among pregnant women in Tanzania. Methods: We examined 910 pregnant women, aged at least 20 years, mean gestational age 27 weeks, from rural (n = 301) and urban (n = 609) areas, during their usual antenatal clinic visits. Hypertension was defined as clinic SBP at least 140 mmHg or DBP at least 90 mmHg. Dietary assessment included dietary diversity score using 16 food groups. Multiple logistic regression analysis was used to assess the independent association of risk factors associated with prevalence of hypertension. Results: A total of 62 women (6.9%) had HDP, prevalence being higher in urban (8.1%) compared to rural area (4.4%). For the urban area, mother's age [odds ratio (OR) 1.10, 95% confidence interval (CI) 1.03–1.20], gestational age (OR 1.10, 95% CI 1.02–1.20), mid-upper arm circumference (OR 1.13, 95% CI 1.01–1.23), dietary diversity score (OR 1.31, 95% CI 1.20–1.60) and being HIV-positive (OR 2.40, 95% CI 1.10–5.18) were independently associated with HDP. When adjusted for proteinuria, associations with HIV status and mid-upper arm circumference weakened. In the rural area, HDP risk increased with age and gestational age. Conclusion: Prevalence of HDP was higher in urban compared to rural area, which points at high risk for preterm delivery, low birth weight and future cardiovascular diseases. The observed risk factors identify risk groups to be screened and targeted for prevention. The role of HIV status needs to be further explore

Basal Metabolic Rate And Energy Expenditure Of Rural Farmers In Magubike Village, Kilosa District, Tanzania

Measurement of basal metabolic rate (BMR) provides an important baseline for the determination of an individual’s total energy requirement. The study sought to establish human energy expenditure of rural farmers in Magubike village in Tanzania, through determination of BMR, physical activity level (PAL) and total energy expenditure (TEE). In addition, the study intended to provide an indication of the level of energy requirement for the rural people of Tanzania. The objective of the study was to determine energy expenditure of farmers in comparison to the mean caloric intake per capita and the WHO/FAO recommended energy requirements for developing countries. A cross-sectional study design involving 33 male and 31 female farmers was conducted on randomly selected households. Basal Metabolic rate and household activities were measured by indirect calorimetry, using the Douglas bag technique. Physical activity Level was measured by twenty-four hour activity diary and TEE calculated as a product of BMR and PAL. Men’s BMR was 4.7 MJ/day while that of women was 4.3 MJ/day. Farmers mean PAL was 2.20 ± 0.25 in men and 2.05 ± 0.23 in females and TEE was 10.24 MJ/day in men and 8.57 MJ/day in women. Both BMR and TEE were higher in men than in women. The measured energy expenditure for digging and weeding were 1.57 ± 0.3 kJ/min; 1.36 ± 0.31kJ/min in men and 1.58 ± 0.3 kJ/min; 1.49 ± 0.33 kJ/min in women. It was revealed that total energy expenditure of farmers in Magubike village was high with the values being above the mean daily calorie requirement per capita for Tanzania (8.15 MJ/day) but within the WHO/FAO recommended energy requirements (11.26 MJ/day) for developing countries. High energy expenditure was attributed to high energy levels spent in farm activities which were manual and labour intensive. This is likely to be the situation in many rural areas of Tanzania. More work on measurement of costs of farm activities and farmers work capacity are necessary to provide recommendations on energy needs of rural farmers

Nutritional Quality And Utilization Of Local And Improved Cowpea Varieties In Some Regions In Tanzania

Cowpeas are grown for their leaves and grains both of which are used as relish or side dishes together with the staple food. Little information is available on the nutritional quality of local and improved cowpea varieties grown in Tanzania as well as the recipes in which they are ingredients. This study was done to investigate cowpea utilization in Iringa and Dodoma regions of Tanzania. A cross-sectional survey was carried out where a total of 517 farmers were interviewed using a pre-tested structured questionnaire. Proximate and mineral composition of different varieties of cowpea grains and leaves were determined using standard AOAC methods. More than half of the households interviewed consumed cowpeas in one or more forms. Most cowpea recipes included them as relish being eaten with rice or stiff porridge (ugali), a mixture of dehulled maize and cowpea grains (kande) and cowpea buns (bagia). Improved cowpea varieties had relatively higher fat content ranging from 8 to 11.2% compared to local varieties (5.4%). Local cowpea grains had higher levels of calcium varying between 958.1 and 992.4 mg/kg than dehulled cowpea (360 to 364 mg/kg) and cowpea flour (303 to 311 mg/kg). Zinc ranged from 32.6 to 31.5 mg/kg, while iron content ranged from 27.6 to 28.9 mg/kg. Fresh cowpea leaves had the highest levels of minerals, with calcium varying between 1800.6 and 1809.6 mg/kg, zinc between 36.1 and 36.0 mg/kg and iron between 497.0 and 499.5 mg/kg. The improved cowpea varieties, IT99K-7212-2-1 (23.8 mg/kg) and IT96D-733 (21.2 mg/kg) had the highest iron content. IT99K-7-21-2-2-1 (32.2 mg/kg) and IT97K499-38 (28.3 mg/kg) had the highest zinc concentration. The bagia (cowpea buns), prepared in Dodoma had higher mineral composition, calcium (893mg/kg), zinc (13.7 mg/kg) and iron (16.3 mg/kg) compared to those prepared in Iringa; calcium (32.6mg/kg), zinc (4.96 mg/kg) and iron (5.2 mg/kg). The cowpea daily per capita consumption for the majority of the households surveyed ranged from 41 to 200 gm. The contribution of micro and macro nutrients is significant for both developed lines and local varieties but with leaves having greater mineral content than the grains; hence, promotion of consumption of the leaves alongside the grains would be of nutritional advantage. Additionally, farmers should be encouraged to plant the higher yielding cowpea varieties and preferred local varieties

The benzimidazole anthelmintic agents - a review

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