ABSTRACT
BACKGROUND :Approximately 200 million children globally fail to fulfil their development potential due to malnutrition, poor health, and unstimulating environments. Children in Kabale, Uganda, may be at particularly high risk as the rate of malnutrition in the region is likely to impact development. The study aimed to identify possible determinants influencing developmental milestones of breastfed and non-breastfed children aged 0-23 months. MATERIALS AND METHODSThe study was conducted at the young child clinic of Kabale hospital, among 250 children aged 0-23 months and their caregivers, for two months. The study adopted a comparative cross-sectional design, and systematic random sampling was used to select the respondents for the study. The socio-demographic characteristics, nutritional status, and feeding practices were assessed using structured pretested questionnaires. Developmental milestones of the children (communication, motor, fine motor, problem-solving, and social skills) were assessed using the modified ages and stages questionnaires. The data collected was tabulated, analysed statistically, and the results interpreted. RESULTS :Developmental scores were not associated with breastfeeding and minimum meal frequency. A milestone achievement of communication skills was associated with caregiver's education, caregiver's age and length-for-age. Gross motor scores were associated with the caregiver's age, weight-for-age, and length for age. Achievement of fine motor skills was associated with caregiver's education, caregiver's age, child's age, length for age, and children who met the minimum dietary diversity score. Problem-solving scores were associated with child's age, weight for age, length for age, and children who met the minimum dietary diversity. Personal social scores were associated with lower caregiver's age and normal weight for age Conclusion: Developmental scores were not associated with breastfeeding and minimum meal frequency. Development in early childhood was mainly associated with caregiver's age, caregiver's education, child's age, weight for age, length for age, and minimum dietary diversity score. Children under the care of younger caregivers and those who attained normal nutrition status had significantly more developed motor and social skills compared to children with older caregivers and undernourished children, respectively.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child Nutrition Disorders , Child Development , Anthropometry , Nutritional Status , Breast FeedingABSTRACT
Objectives: The objective of this study was to identify gaps in the adequacy of nutrient intakes, and food-based recommendations to fill those gaps, from complementary diets of 6-23 mo old children in two agro-ecological zones of rural Kenya. Methods: In a high rainfall area of Western Kenya (Vihiga) and a semi-arid area of Eastern Kenya (Kitui), food and nutrient intakes from complementary diets of 6-8, 9-11, and 12-23 mo old breastfed children were quantified using 24-hour dietary recalls. Optifood, an automated linear programming tool, was used to identify recommended nutrient intakes (RNIs) that could not be achieved using locally available foods (problem nutrients) and optimal food-based recommendations that would improve dietary adequacy for 11 nutrients, if adopted. Model constraints ensured they conformed to local food patterns. Results: Problem nutrients were iron and zinc (all age/location subgroups), plus calcium in Vihiga and vitamin B12 in 12-23 mo olds in Kitui. Dietary vitamins A and C were adequate in most subgroups, while most B-vitamins were moderately inadequate in most subgroups. Specific recommendations varied somewhat by subgroup, but included increased weekly servings of green leafy vegetables, legumes, existing fortified cereals, dairy products, plus millet flour and meat, fish or egg in Kitui, and sardines in Vihiga. Conclusions: In conclusion, food-based recommendations alone can ensure >65% of RNIs for all nutrients, except for iron and zinc (all subgroups), and folate or niacin (12-23 mos), which require external solutions such as new targeted fortified foods. These results provide an evidence base for designing appropriate interventions for improved complementary diets.
ABSTRACT
Objectives: To document serum zinc deficiency in pregnant women of Naivasha and to examine factors associated with zinc defeiency among pregnant women in Naivasha. Methods: A cross-sectional analytical study design was conducted on 172 pregnant women in a mid-sized urban industrial area, applying systematic random sampling to obtain the sample size. Serum zinc levels were analyzed by atomic absorption spectrophotometer. Structured questionnaire was used to obtain socio and demographic factors of the women. Dietary intakes were assessed using 24-hr dietary recal and a food frequency questionnaire. Statistical analysis was done using logistic and linear regression. Results: The mean serum zinc level was 66 µ66g/dl±14SD ranging from 39 to 123 µg/dl. ZD was observed in 66.9 percent of the study subjects and a 75 percent of them were in low socio-economic status. Parity was the only factor associated with ZD (AOR=3.65;95%CI:1.27-10.49;p=0.016). There was no significant association between dietary zinc intake, socio-econimc status with ZD, but women consuming Vitamin C below the RDA had a 2.62 fold risk (95%CI:0.55-12.37) of developing ZD. A p-value of <0.05 statistical significant at 95% confidence level was used. Conclusions: Zinc deficiency is a major public health concern in this area of Kenya. This high prevalence is related to other factors other than dietary zinc intakes. These includes factors related to absorption of zinc and inadequate provision of high bioavailable foods for optimal zinc absorption in the gut. Zinc levels should be assessed in a wider population of Kenyan pregnant women in order to determine zinc prevalence across Kenyan communities.