Food insecurity, dietary diversity and the right to adequate food among households in landslide-prone communities in Eastern Uganda: A cohort study.

We assessed food insecurity, dietary diversity and the right to adequate food among households in communities in Eastern Uganda that were affected by major landslides in 2010 and 2018. A prospective cohort study was applied to select 422 households during May-August (the food-plenty season) of 2019. In January-March (the food-poor season) of 2020, 388 households were re-assessed. Socio-demographic, food security, dietary diversity and right to adequate food data were collected using structured questionnaires. Four focus groups discussions and key informant interviews with 10 purposively sampled duty-bearers explored issues of food insecurity, dietary and the right to adequate food. The affected households had significantly higher mean (SE) food insecurity scores than controls, both during the food plenty season: 15.3 (0.5) vs. 10.8 (0.5), and during food-poor season: 15.9 (0.4) vs. 12.5 (0.0). The affected households had significantly lower mean (SE) dietary diversity scores than controls during the food plenty season: 5.4 (0.2) vs. 7.5 (0.2) and during the food poor season: 5.2 (0.2) vs. 7.3 (0.1). Multivariate analyses showed that the disaster event, education and main source of livelihood, were significantly associated with household food security and dietary diversity during the food-plenty season whereas during the food-poor season, the disaster event and education were associated with household food security and dietary diversity. During both food seasons, the majority of affected and control households reported to have consumed unsafe food. Cash-handout was the most preferred for ensuring the right to adequate food. Comprehension and awareness of human rights principles and state obligations were low. The severity of food-insecurity and dietary diversity differed significantly between the affected and control households during both food seasons. Moreover, the right to adequate food of landslide victims faced challenges to its realization. There is need for policy and planning frameworks that cater for seasonal variations, disaster effects and right to adequate food in order to reduce landslide victims' vulnerability to food insecurity and poor dietary diversity. In the long-term, education and income diversification program interventions need to be integrated into disaster recovery programs since they are central in enhancing the resilience of rural livelihoods to shocks and stressors on the food system.

Dietary intake and socio-economic predictors of inadequate energy and nutrient intake among women of childbearing age in Karamoja sub-region of Uganda.

BACKGROUND: Karamoja sub-region is the most food insecure part of Eastern Africa. The poor status of food security in the sub-region is reflected in the high rate of undernutrition among women of childbearing age (WCBA) and children under 5 years (CUFY). The sub-region is unique in Uganda in terms of cultural diversity, agro-ecology and rainfall pattern and agricultural practices. However, the influence of these unique characteristics on dietary intake of WCBA in the sub-region is less understood. Therefore, this study examined dietary intake and socio-economic predictors of inadequate energy and nutrient intake among WCBA in Karamoja sub-region. METHODS: A longitudinal study design was used involving 755 WCBA in the harvesting season where 635 were followed-up in the planting season. Data were collected using 24-h recall, dietary diversity and socio-economic and demographic questionnaires. RESULTS: Intake of energy and nutrients were generally significantly higher (p < 0.05) during the planting season than in the harvesting season. Irrespective of the district, physiological status and season, household consumption of plant-based foods was far higher than intake of animal-based foods dominated by starchy stables (76-100%), dark green leafy vegetables (70-100%) and legumes, nuts and seeds (22-97%) depending on the district. Majority of the respondents had two meals (breakfast: 65-100%; supper: 90-100%) with up to 45% of WCBA who consumed alcohol across meal times. .Overall on average, 57.7, 66.6, 78.5, 60.3, 67.7 and 93.7% of WCBA did not meet the recommended daily allowance (RDA) for energy, protein, calcium, iron, zinc and folic acid, respectively. Binary logistic regression revealed that inadequate intake of energy and nutrients significantly increased (p < 0.05) with the status of being lactating/breastfeeding and was influenced by age of WCBA, number of women married, education level and occupation of the household head depending on season. CONCLUSIONS: This study demonstrated that dietary intake of WCBA in Karamoja sub-region was inadequate. Age of WCBA, number of women married, education level and occupation of the household head and spouse and being a lactating/breastfeeding mother were the key socio-economic and demographic factors that influenced inadequate intake of energy and nutrients among WCBA.

Seasonality- and disaster effects on food variety and food insecurity coping strategies among a landslide-prone cohort.

BACKGROUND & AIMS: Landslides may impact on nutritional health among vulnerable populations. However, there is limited data on the seasonal effects of landslides on diet and food security. Among the 2010 and 2018 households affected by the landslides in Eastern Uganda, we assessed seasonality and disaster effects on food varieties consumed and food insecurity coping strategies. This study is among the first to report on seasonal- and disaster effects on food varieties and food insecurity coping strategies among vulnerable populations in Uganda. METHODS: We used a three-stage simple random technique to select a total of 422 households during May-August (food-plenty season) in 2019, of whom 211 had been affected by the landslides and 211 had not (controls). Six months later, in January-March (food-poor season) of 2020, 388 households were re-assessed (191 affected and 197 controls). We analyzed data only from the households that participated in both food seasons to compare results between the two food seasons. Food variety scores (FVS) were obtained by summing the frequency of weekly intakes of 86 food items while a coping index was derived based on the severity weighting of household food insecurity coping strategies. RESULTS: After adjusting for covariates, significantly lower mean (SE) FVS were among the affected than controls during the food-plenty season: 9.3 (0.5) vs 11.4 (0.3), and during the food-poor season: 7.6 (0.5) vs 10.1 (0.1) (P < 0.001 for both). The affected households were more likely to use food insecurity coping strategies compared to controls (mean [SE]: 35.2 [2.1] vs. 27.1 [1.8], P < 0.001) during the food-plenty season and the severity further increased during the food-poor season: 42.1 (2.1) vs. 28.2 (2.1) (P < 0.001). Disaster exposure was associated with both household food varieties and food insecurity coping strategies during both food seasons (P < 0.001). The adjusted models, showed that, the affected compared to the controls had a significantly higher likelihood to rely on 5 of the 11 coping strategies during food-plenty season and 9 of the 11 coping strategies during the food-poor season. CONCLUSION: Low variety diets and coping strategies among disaster affected individuals cut across seasons and implies needs for strong social protection and targeted safety nets irrespective of season.

Household Processing Methods and Their Impact on Bioactive Compounds and Antioxidant Activities of Sweetpotato Genotypes of Varying Storage Root Flesh Colours.

Sweetpotato storage roots, peeled and unpeeled, of varying flesh colours (white, cream, yellow, pale orange, deep orange, and purple) were spectrophotometrically evaluated for their bioactive compounds and antioxidant activities. Roots were boiled, steamed, baked, fried, or microwaved. The unpeeled roots had relatively higher (p < 0.001) bioactive compounds and antioxidant activities than the peeled ones. All cooking methods increased phenolic compounds, flavonoids, and tannins in all genotypes. Significant losses of total carotenoids occurred with all cooking methods (ranging from 24.18 to 172.76 µg/g in raw sweetpotatoes vs. 10.06 to 118.17 µg/g in cooked ones; p < 0.001), except the deep-orange-fleshed genotype, in which frying slightly increased carotenoids from 269.81 to 304.74 µg/g. Microwaving retained 69% vitamin C in the cream-fleshed one, the highest among the cooking methods. Anthocyanins decreased with baking and frying in the purple-fleshed one but increased with other methods; microwaving being highest at 13.9% (17.43 mg/g). While the 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid antioxidant activity decreased with all cooking techniques in some genotypes, ferricyanide-reducing antioxidant potential increased. The retention of bioactive compounds in sweetpotato storage roots depends on the processing method. Thus, to obtain the most health benefits, consumers should use different cooking methods but retain the peels.

Malnutrition and Associated Risk Factors among Children 6-59 Months Old in the Landslide-Prone Bududa District, Eastern Uganda: A Cohort Study.

BACKGROUND: The United Nations Sustainable Development Goal 2.2 calls for an end to all forms of malnutrition. This might be derailed due to persistent landslide disasters in low-income countries like Uganda. OBJECTIVES: The prevalence of malnutrition and the impact of seasonal variations and associated factors were assessed among children aged 6-59 mo in the landslide-affected households in Bududa District, eastern Uganda. METHODS: A prospective cohort study using a 2-stage simple random technique was applied to select 422 households including 392 children during May-August (food-plenty season) 2019. After 6 mo, in January-March (food-poor season) 2020, 388 households and 366 children were assessed. Socioeconomic and demographic data were collected using structured questionnaires. Child malnutrition outcomes were defined according to WHO criteria. Factors associated with malnutrition outcomes were identified by bivariate and multivariate logistic regression. RESULTS: Stunting, underweight, wasting, and overweight prevalences were 37.7%, 13.3%, 3.6%, and 4.3%, respectively, in the food-plenty season and 42.6%, 14.2%, 2.1%, and 2.7%, respectively, in the food-poor season. Residing in the landslide-affected sub-county increased the odds for stunting [adjusted OR (aOR): 1.68; 95% CI: 1.08, 2.59; P = 0.025] and underweight (aOR = 4.25; 95% CI: 1.10, 15.36; P = 0.032) for children in the food-plenty season. Child age, sex, breastfeeding status, a nonimproved drinking water source, migration of any household member, and parents' education were significant risk factors in the food-plenty season. In the food-poor season, parents' education status, loss of any household member, child sex, and child age were significant risk factors. CONCLUSIONS: Stunting and underweight were more prevalent in the food-poor season while wasting and overweight were more prevalent in the food-plenty season. With the exception of child age, child sex, and parents' education, child malnutrition risk factors differed between food-plenty and food-poor seasons. There is a need to address seasonality factors in program interventions targeting children <5 y in landslide-prone areas.

Cup quality profiles of Robusta coffee wilt disease resistant varieties grown in three agro-ecologies in Uganda.

BACKGROUND: The recently developed Robusta coffee wilt disease resistant (CWD-r) varieties in Uganda outperform the local landraces, both in yield and resilience. However, their uptake has been slow due to limited information on their cup worth. This study profiled the cup worth of the five most commonly grown CWD-r across the Lake Victoria Crescent, Western Mid-altitude farmland and Central Wooded Savannah agro-ecologies. RESULTS: Significant correlations (P ≤ 0.05) were observed between soil nutrients and coffee bean size but this was not the case for biochemical and cup quality. The proportion of coffee beans retained on screen 15; minimum acceptable size through coffee commercial markets, ranged from 58.09% in Mukono to 92.49% in Mityana. Interestingly, the bean size of variety KR4 was hardly influenced by environmental variations, with portions of beans retained on screen 15 being relatively the same (80.30% Ibanda, 89.50% Mukono, 98.20% Mityana). Coffee cup quality for most of the varieties was scored as premium (70-79%) across three agro-ecologies, with the exception of KR4, which was scored specialty grade (≥80%). Coffee blends generated were used to make coffee products with specialty score (82.25%) and a distinctive aroma complex. CONCLUSION: In this study, blends of CWD-r resulted in superior cup scores (76-82%). These findings show that CWD-r varieties have a high cup worth with potential for wide adaptation in Uganda's Robusta coffee growing agro-ecologies. Most importantly, variety KR4 has resilience across three agro-ecologies with a consistent high bean size and superior cup quality, making it a candidate variety for the market and breeding. © 2021 Society of Chemical Industry.

The Potential of Sweetpotato as a Functional Food in Sub-Saharan Africa and Its Implications for Health: A Review.

Increasing urbanization in developing countries has resulted in busier lifestyles, accompanied by consumption of fast foods. The consequence is an increased prevalence in noncommunicable diseases (NCDs). Food-based approaches would be cheaper and more sustainable in reducing these NCDs compared to drugs, which may have side effects. Studies have suggested that consuming functional foods could potentially lower NCD risks. Sweetpotato is regarded as a functional food because it contains bioactive compounds. Recently, sweetpotato has gained attention in sub-Saharan Africa (SSA), but research has focused on its use in alleviating micronutrient deficiencies such as vitamin A deficiency, particularly the orange-fleshed variety of sweetpotato. Some studies conducted in other parts of the world have investigated sweetpotato as a functional food. There is a need to characterize the sweetpotato varieties in SSA and determine how processing affects their bioactive components. This review highlights some of the studies conducted in various parts of the world on the functionality of sweetpotato, its bioactive compounds, and how these are influenced by processing. In addition, the potential health benefits imparted by sweetpotato are expounded. The knowledge gaps that remain in these studies are also addressed, focusing on how they can direct sweetpotato research in SSA.

Stakeholders' perceptions of the nutrition and dietetics needs and the requisite professional competencies in Uganda: a cross-sectional mixed methods study.

BACKGROUND: Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders' perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor's degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda. METHODS: A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor's degrees in HN/HND obtained from the Makerere and Kyambogo Universities in 2005-2016; 14 academic staff that train HN/HND in the two universities; and 11 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey; data from other participants was through face to face interviews using researcher administered questionnaires. RESULTS: Most HN/HND respondents (84.8%) obtained their Bachelor's degrees from Kyambogo University; 61.4% graduated in 2013-2016. Most (64.3%) academic staff respondents were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges cutting across different Sustainable Development Goals. The nutrition and dietetics interventions requested for, provided, and considered a priority for communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main competency domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research; and advocacy, communication, and awareness creation. CONCLUSIONS: This study shows that nutrition and dietetics challenges in Uganda are multiple and multifaceted; HN/HND graduates are employed in different sectors, provide nutrition-specific and sensitive services in a multisectoral environment, and are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps in some of the areas they are expected to exhibit competency. We recommend using these findings as a basis for obtaining stakeholder consensus on the key competencies that should be exhibited by all HN/HND graduates in Uganda; developing a HN/HND competency-based education model and a national HN/HND training and practice standard; and undertaking further research to understand the quality and relevancy of HN/HND curricula to Uganda's job market requirements.

Fortified Foods Are Major Contributors to Apparent Intakes of Vitamin A and Iodine, but Not Iron, in Diets of Women of Reproductive Age in 4 African Countries.

BACKGROUND: Food fortification is implemented to increase intakes of specific nutrients in the diet, but contributions of fortified foods to nutrient intakes are rarely quantified. OBJECTIVES: We quantified iron, vitamin A, and iodine intakes from fortified staple foods and condiments among women of reproductive age (WRA). METHODS: In subnational (Nigeria, South Africa) and national (Tanzania, Uganda) cross-sectional, clustered household surveys, we assessed fortifiable food consumption. We estimated daily nutrient intakes from fortified foods among WRA by multiplying the daily apparent fortifiable food consumption (by adult male equivalent method) by a fortification content for the food. Two fortification contents were used: measured, based on the median amount quantified from individual food samples collected from households; and potential, based on the targeted amount in national fortification standards. Results for both approaches are reported as percentages of the estimated average requirement (EAR) and recommended nutrient intake (RNI). RESULTS: Fortified foods made modest contributions to measured iron intakes (0%-13% RNI); potential intakes if standards are met were generally higher (0%-65% RNI). Fortified foods contributed substantially to measured vitamin A and iodine intakes (20%-125% and 88%-253% EAR, respectively); potential intakes were higher (53%-655% and 115%-377% EAR, respectively) and would exceed the tolerable upper intake level among 18%-56% of WRA for vitamin A in Nigeria and 1%-8% of WRA for iodine in Nigeria, Tanzania, and Uganda. CONCLUSIONS: Fortified foods are major contributors to apparent intakes of vitamin A and iodine, but not iron, among WRA. Contributions to vitamin A and iodine are observed despite fortification standards not consistently being met and, if constraints to meeting standards are addressed, there is risk of excessive intakes in some countries. For all programs assessed, nutrient intakes from all dietary sources and fortification standards should be reviewed to inform adjustments where needed to avoid risk of low or excessive intakes.

Efficacy of In Ovo Delivered Prebiotics on Growth Performance, Meat Quality and Gut Health of Kuroiler Chickens in the Face of a Natural Coccidiosis Challenge.

A study was carried out to assess the efficacy of prebiotic delivered in ovo on performance, carcass traits, meat quality and gut health in the face of a natural coccidiosis infection in Kuroiler chickens. On d 12 of incubation, 150 fertile eggs were divided into a prebiotic group injected with trans-galactooligosaccharides (Bi2tos) and a control group uninjected. Hatched chicks from each group were further divided: One group received antibiotic chick formula while the other was left untreated, giving rise to 4 groups-Control (C), Antibiotic (A), Bi2tos (B), and Bi2tos + Antibiotic (AB). Prebiotic improved growth performance at six weeks of age, AB birds were the heaviest at the end of the rearing period. The highest intestinal lesion scores and oocyst counts were recorded in C birds. B group had a slightly higher carcass weight and cuts yields tended to be higher in treated groups compared to C. Meat from B group displayed a higher amount of polyunsaturated fatty acids compared to C and a positively lower n-6/n-3 ratio compared to C and A. In conclusion, prebiotics with or without antibiotics reduced severity of intestinal lesions and oocyst excretion induced by natural infection with Eimeria, with positive effects on Kuroiler chicken productive traits.

Child development, growth and microbiota: follow-up of a randomized education trial in Uganda.

BACKGROUND: Undernutrition impairs child development outcomes and growth. In this follow-up study of an open cluster-randomized intervention trial we examined the effects of an education package delivered to mothers in rural Uganda on their children's development, growth and gut microbiota at 36 months of age. METHODS: The parental trial included 511 mother-child pairs recruited when the children were 6-8 months. In that trial, a nutrition, stimulation and hygiene education was delivered to mothers in the intervention group while the control group received routine health care. A follow-up sample of 155 pairs (intervention n = 77, control n = 78) were re-enrolled when the children were 24 months. Developmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development (BSID-III) composite scores for cognitive (primary endpoint), language and motor development. Development outcomes were also evaluated using the Ages and Stages Questionnaire (ASQ) and the Mullen Scales of Early Learning (MSEL). Other outcomes included growth and gut microbiota composition. RESULTS: The demographic characteristics were not different (P > 0.05) between the intervention and control groups and similar to those of the parental study. The intervention group had higher BSID-III scores than controls, with mean difference 10.13 (95% confidence interval (CI): 3.31-17.05, P = 0.002); 7.59 (1.62-13.66, P = 0.01); 9.00 (2.92-15.40, P = 0.005), for cognitive, language and motor composite scores, respectively. An improvement in the intervention compared to the control group was obtained for both the ASQ and the MSEL scores. The mean difference in height-for-age z-score was higher in the intervention compared to the control group: 0.50 (0.25-0.75, P = 0.0001). Gut microbiota composition did not differ significantly between the two study groups. CONCLUSIONS: The maternal education intervention had positive effects on child development and growth at three years, but did not alter gut microbiota composition. This intervention may be applicable in other low-resource settings. TRIAL REGISTRATION: ClinicalTrials.gov registration number NCT02098031.

Realization of the right to adequate food and the nutritional status of land evictees: a case for mothers/caregivers and their children in rural Central Uganda.

BACKGROUND: In developing countries like Uganda, the human right to adequate food (RtAF) is inextricably linked to access to land for households to feed themselves directly through production or means for its procurement. Whether RtAF is enjoyed among Ugandan land evictees, is unknown. We therefore explored this among land evictees (rights-holders) in Wakiso and Mpigi districts in rural Central Uganda. We assessed food accessibility and related coping strategies, diet quality and nutritional status of children 6-59 months old, and their caregivers. Effectiveness of the complaint and redress mechanisms in addressing RtAF violations was also explored. METHODS: In this cross-sectional study, quantitative data was collected using a structured questionnaire, with food security and nutritional assessment methods from a total of 215 land evictees including 187 children aged 6-59 months. Qualitative data was collected by reviewing selected national and international documents on the RtAF and key informant interviews with 15 purposively sampled duty-bearers. These included individuals or representatives of the Uganda Human Rights Commission, Resident District Commissioner, Sub-county Chiefs, and local Council leaders. RESULTS: We found that 78% of land evictees had insufficient access to food while 69.4% had consumed a less diversified diet. A majority of evictees (85.2%) relied on borrowing food or help from others to cope with food shortages. Of the 187 children assessed, 9.6% were wasted, 18.2% were underweight and 34.2% were stunted. Small, but significant associations, were found between food accessibility, diet quality, food insecurity coping strategies; and the nutritional status of evictees. We observed that administrative, quasi-judicial and judicial mechanisms to provide adequate legal remedies regarding violations of the RtAF among evictees in Uganda are in place, but not effective in doing so. CONCLUSION: Land eviction without adequate legal remedies is a contributor to food insecurity and undernutrition in rural Central Uganda. It is essential that the Government strengthens and enforces the policy and legal environment to ensure adequate and timely compensation of evictees in order to reduce their vulnerability to food insecurity.

Nutrition, hygiene, and stimulation education to improve growth, cognitive, language, and motor development among infants in Uganda: A cluster-randomized trial.

Stunting is associated with impaired cognitive and motor function. The effect of an education intervention including nutrition, stimulation, sanitation, and hygiene on child growth and cognitive/language/motor development, delivered to impoverished mothers in Uganda, was assessed. In a community-based, open cluster-randomized trial, 511 mother/children dyads aged 6-8 months were enrolled to an intervention (n = 263) or control (n = 248) group. The primary outcome was change in length-for-age z-score at age 20-24 months. Secondary outcomes included anthropometry and scores on the 2 developmental scales: Bayley Scales of Infant and Toddler Development-III and the Ages and Stages Questionnaire. There was no evidence of a difference in mean length-for-age z-score at 20-24 months between the 2 study groups: 0.10, 95% CI [-0.17, 0.36], p = .49. The intervention group had higher mean composite development scores than the controls on Bayley Scales of Infant and Toddler Development-III, the mean difference being 15.6, 95% CI [10.9, 20.2], p = .0001; 9.9, 95% CI [6.4, 13.2], p = .0001; and 14.6, 95% CI [10.9, 18.2], p = .0001, for cognitive, language, and motor composite scores, respectively. The mean difference in scores from the Ages and Stages Questionnaire were 7.0, 95% CI [2.9, 11.3], p = .001; 5.9, 95% CI [1.2, 10.3], p = .01; 4.2, 95% CI [1.7, 6.7], p = .001; 8.9, 95% CI [5.3, 12.3], p = .0001; and 4.4, 95% CI [0.0, 8.8], p = .05, for communication, gross motor, fine motor, problem solving, and personal-social development, respectively. The intervention education delivered to mothers promoted early development domains in cognitive, language, and motor development but not linear growth of small children in impoverished rural communities in Uganda. Our study showed that child development may be improved with a relatively low cost intervention strategy. This trial was registered at ClinicalTrials.gov as NCT02098031.

Modelling the impact of stunting on child survival in a rural Ugandan setting.

BACKGROUND: Uganda ranks among the top 10 countries in the world for newborn and child mortality rates and among the top 34 for burden of stunting. This study was conducted to model the impact of stunting on child mortality in the southwest region of Uganda where the prevalence of stunting and child mortality are of great public health concern. METHODS: The study was conducted in Buhweju district in the southwest region of Uganda. The study was cross-sectional involving use of a structured household questionnaire, focus group discussions and interviews with key informants in order to gather relevant information on infant and young child feeding (IYCF) and coverage of antenatal care (ANC) and vaccination programs. The survey of stunting, vaccination and ANC services covered 221 children aged 6-59 months while the assessment of IYCF practices covered 83 children aged 0-23. The Lives Saved Tool (LiST) was used to estimate the impact of stunting on child mortality and cases of stunting averted. RESULTS: The study findings indicated that only 33% of the mothers had knowledge of optimal IYCF and 39% of the sampled children were exclusively breastfed. The majority of the mothers (57%) breastfed their children for less than 2 years and only 31% of the mothers practiced appropriate introduction of complementary foods at 6 months. Only 17% of the 0-23-month-olds received a good standard of IYCF. Only 37% of the mothers reportedly attended ANC 4 times or more during pregnancy and among children aged 6-59 months, only 28% were fully vaccinated. The high impact LiST model estimated that 1297 children under 5 years would be saved and 24,850 cases of stunting averted in the study district. CONCLUSIONS: The study concludes that IYCF practices and coverage of expanded programme on immunization (EPI) and ANC in the study population are sub-optimal thus the high prevalence of stunting and child mortality in the region. LiST demonstrated that prevention of stunting would reduce child mortality in rural Uganda. Therefore, increased investment in cost-effective child survival interventions targeting rural areas of Uganda would have a significant impact on stunting and child mortality.

Predictors of Stunting in Children Aged 6 to 59 Months: A Case-Control Study in Southwest Uganda.

BACKGROUND: Stunting affects close to 2.4 million children in Uganda, and it is among the major contributors to the annual loss in productivity of the equivalent of US$899 million. OBJECTIVE: This study sought to identify the key underlying causes of the persistently high stunting rates in a region of Uganda known to have low poverty rates and a high agricultural output. METHODS: A matched case-control study was conducted in Buhweju district, southwest Uganda to compare prior exposures between stunted children (cases) and nonstunted children (controls). RESULTS: The sample comprised 56 cases and 112 controls, totaling 168 children aged 6 to 59 months. There were almost equal numbers of boys and girls in the sample. Boys were significantly more likely to be stunted compared to girls (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.1-4.2; P < .05). Stunted children were significantly less likely to be introduced to complementary foods at an appropriate age and their primary caregivers lacked knowledge about stunting. The odds of stunting were 2.4 times greater for children in food-insecure households compared to those in food-secure households (OR: 2.4, 95% CI: 1.1-5.0; P < .05) and 4.5 times greater among children who resided in poor quality houses (OR: 4.5, 95% CI: 1.4-13.0; P < .05). CONCLUSION: Low access to appropriate complementary diets, sex of child, food insecurity, poor socioeconomic status, and low knowledge about stunting were the main predictors of childhood stunting in the study population.

Contribution of forest foods to dietary intake and their association with household food insecurity: a cross-sectional study in women from rural Cameroon.

OBJECTIVE: To determine the contribution of forest foods to dietary intake and estimate their association with household food insecurity. DESIGN: Cross-sectional survey conducted among 279 households. Using a 7 d recall questionnaire, information on household food consumption was collected from women and used to determine the household dietary diversity score, food variety score and forest food consumption score (FFCS). Household Food Insecurity Access Scale (HFIAS) score was determined and Spearman rank correlation was used to establish the relationship between consumption of forest foods and HFIAS score. Women's dietary intake was estimated from two 24 h recalls. The contribution of forest foods to women's nutrient intakes was calculated and women's nutrient intakes were compared with estimated average nutrient requirements. SETTING: Rural forest-dependent households in twelve villages in eastern and southern Cameroon. SUBJECTS: Household heads and their non-pregnant, non-lactating spouses. RESULTS: Forty-seven unique forest foods were identified; of these, seventeen were consumed by 98 % of respondents over the course of one week and by 17 % of women during the two 24 h recall periods. Although forest foods contributed approximately half of women's total daily energy intake, considerably greater contributions were made to vitamin A (93 %), Na (100 %), Fe (85 %), Zn (88 %) and Ca (89 %) intakes. Despite a highly biodiverse pool of foods, most households (83 %) suffered from high food insecurity based on the HFIAS. A significant inverse correlation was observed between the HFIAS score and the FFCS (r 2=-0·169, P=0·0006), demonstrating that forest foods play an important role in ensuring food security in these forest-dependent communities. CONCLUSIONS: Forest foods are widely consumed by forest-dependent communities. Given their rich nutrient content, they have potential to contribute to food and nutrition security.

Shift in performance of food safety management systems in supply chains: case of green bean chain in Kenya versus hot pepper chain in Uganda.

BACKGROUND: This study investigates the level of design and operation of food safety management systems (FSMS) of farmers and export traders in Kenya and Uganda. FSMS diagnostic tools developed for the fresh produce chain were used to assess the levels of context riskiness, FSMS activities and system output in primary production (n = 60) and trade (n = 60). High-risk context characteristics combined with basic FSMS are expected to increase the risk on unsafe produce. RESULTS: In Uganda both farmers and export traders of hot peppers operate in a high- to moderate-risk context but have basic FSMS and low systems output. In Kenya, both farmers and export traders of green beans operate in a low- to moderate-risk context. The farmers have average performing FSMS, whereas export trade companies showed more advanced FSMS and system output scores ranging from satisfactory to good. CONCLUSION: Large retailers supplying the EU premium market play a crucial role in demanding compliance with strict voluntary food safety standards, which was reflected in the more advanced FSMS and good system output in Kenya, especially traders. In Kenya, a clear shift in more fit-for-purpose FSMS and higher system output was noticed between farms and trade companies. In the case of Uganda, traders commonly supply to the less demanding EU wholesale markets such as ethnic specialty shops. They only have to comply with the legal phytosanitary and pesticide residue requirements for export activities, which apparently resulted in basic FSMS and low system output present with both farmers and traders. © 2015 Society of Chemical Industry.

Nutrients and bioactive compounds content of Baillonella toxisperma, Trichoscypha abut and Pentaclethra macrophylla from Cameroon.

Baillonella toxisperma, Pentaclethra macrophylla and Trichoscypha abut are important foods for communities living around forests in Cameroon. Information on the nutritional value and bioactive content of these foods is required to establish their contribution to the nutrition and health of the communities. Samples of the three foods were obtained from four villages in east and three villages in south Cameroon. The foods were analyzed for proximate composition, minerals and bioactive content using standard chemical analysis methods. T. abut was found to be an excellent source of bioactive compounds; flavonoids (306 mg/100 g), polyphenols (947 mg/100 g), proanthocyanins (61.2 mg/100 g), vitamin C (80.05 mg/100 g), and total oxalates (0.6 mg/100 g). P. macrophylla was found to be a rich source of total fat (38.71%), protein (15.82%) and total fiber (17.10%) and some bioactive compounds; vitamin E (19.4 mg/100 g) and proanthocyanins (65.0 mg/100 g). B. toxisperma, was found to have high content of carbohydrates (89.6%), potassium (27.5 mg/100 g) and calcium (37.5 mg/100 g). Flavonoids, polyphenols, vitamins C and E are the main bioactive compounds in these forest foods. The daily consumption of some of these fruits may coffer protection against some ailments and oxidative stress. Approximately 200 g of either B. toxisperma or P. macrophylla, can supply 100% iron and zinc RDAs for children aged 1-3 years, while 300 g of the two forest foods can supply about 85% iron and zinc RDAs for non-pregnant non-lactating women. The three foods provide 100% daily vitamins C and E requirements for both adults and children. The results of this study show that Baillonella toxisperma, Pentaclethra macrophylla and Trichoscypha abut can considerably contribute towards the human nutrient requirements. These forest foods also contain substantial levels of health promoting phytochemicals notably flavonoids, polyphenols, vitamins C and E. These foods therefore have potential to promote nutrition and health, especially among forest dependent communities who consume them in substantial amounts.

The importance of using food and nutrient intake data to identify appropriate vehicles and estimate potential benefits of food fortification in Uganda.

BACKGROUND: Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification. OBJECTIVE: To use food intake to determine nutrient inadequacies in children aged 24 to 59 months and nonpregnant women of reproductive age, and to model the adequacy of mass fortification. METHODS: Data were collected by the 24-hour recall method in three regions. Usual nutrient intakes were calculated by adjusting actual intake distribution for the intraindividual variance. The impact of fortification on intake adequacy was simulated. RESULTS: The nutrients with the highest prevalence of inadequate intake across regions were vitamin A (30% to 99%), vitamin B12 (32% to 100%), iron (55% to 89%), zinc (18% to 82%), and calcium (84% to 100%). According to simulations, fortification of vegetable oil and sugar with vitamin A would reduce the prevalence of vitamin A inadequacy in the Western and Northern regions; in Kampala it would eliminate vitamin A inadequacy but would cause 2% to 48% of children to exceed the Tolerable Upper Intake Level (UL). The proposed fortification of wheat flour would reduce the prevalence of inadequate intakes of thiamine, riboflavin, folate, and niacin in Kampala, but would have little impact in the other two regions due to low flour consumption. CONCLUSIONS: Micronutrient fortification of vegetable oil and sugar in all regions and of wheat flour in Kampala would reduce the prevalence of micronutrient inadequacies. However, the wheat flour formulation should be modified to better meet requirements, and the vitamin A content in sugar should be reduced to minimize the risk of high intakes. Maize flour may be suitable for targeted fortification, but prior consolidation of the industry would be required for maize flour to become a good vehicle for mass fortification.

The effect of storage time and agroecological zone on mould incidence and aflatoxin contamination of maize from traders in Uganda.

A study to determine mould incidence and aflatoxin contamination of maize kernels was carried out among dealers (traders) in the three agroecological zones of Uganda. The maize kernels were categorized into those stored for two to six months or for more than six months to one year. Results indicate that the mean moisture content of the kernels was within the recommended safe storage levels of < or =15% but was significantly lower in the Highland maize kernels followed by the Mid-Altitude (dry) kernels while the Mid-Altitude (moist) kernels had the highest levels. Across the agroecological zones, Aspergillus, Fusarium, Penicillium and Rhizopus were the most predominant fungal genera identified and, among their species, A. niger had the highest incidence, followed by A. flavus, F. verticillioides, A. wentii, A. penicillioides and Rhizopus stolonifer. There were more aflatoxin positive samples from the Mid-Altitude (moist) zone (88%) followed by those samples from the Mid-Altitude (dry) zone (78%) while samples from the Highland zone (69%) were least contaminated. Aflatoxin levels increased with storage time such that maize samples from the Mid-Altitude (dry and moist) stored for more than six months had mean levels greater than the 20 ppb FDA/WHO regulatory limits. Aflatoxin B1 was the most predominant type and was found to contaminate maize kernels from all the three agroecological zones. These results indicate that maize consumers in Uganda are exposed to the danger of aflatoxin poisoning. Thus, there is the need for policy makers to establish and enforce maize quality standards and regulations related to moulds and aflatoxins across the agroecological zones to minimize health hazards related to consumption of contaminated kernels.