Determinants of low birth weight in the context of maternal nutrition education in urban informal settlements, Kenya.

Inadequate knowledge in maternal nutrition is one of the determinants of low birth weight. However, little evidence is available on whether maternal nutrition counselling alone can influence birth weight among women from low socioeconomic households. This study assessed the effect of prenatal maternal nutritional counselling on birth weight and examined the related risk factors. A cluster randomized controlled trial was conducted to assess the effectiveness of home-based maternal nutritional counselling on nutritional outcomes, morbidity, breastfeeding, and infant feeding practices by the African Population and Health Research Center in two urban informal settlements of Nairobi. The intervention group received monthly antenatal and nutritional counselling from trained community health volunteers; meanwhile, the control group received routine antenatal care. A total of 1001 participants were included for analysis. Logistic regression was applied to determine associations between low birth weight and maternal characteristics. A higher prevalence of low birth weight was observed in the control group (6.7%) than in the intervention group (2.5%; P<0.001). Logistic regression identified significant associations between birth weight and intervention group (adjusted odds ratio (AOR)=0.26; 95% confidence interval (CI), 0.10-0.64); maternal height <154.5 cm (AOR=3.33; 95% CI, 1.01-10.96); last antenatal care visits at 1st or 2nd trimesters (AOR=9.48; 95% CI, 3.72-24.15); pre-term delivery (AOR=3.93; 95% CI, 1.93-7.98); maternal mid-upper arm circumference <23 cm (AOR=2.57; 95% CI, 1.15-5.78); and cesarean delivery (AOR=2.27; 95% CI, 1.04-4.94). Nutrition counselling during pregnancy reduced low birth weight and preterm births, which was determined by women of short stature, early stoppage of antenatal visit, and cesarean delivery.

Risk factors for symptoms of gastrointestinal illness in rural town Isiolo, Kenya.

This study assesses risk factors for food-borne gastrointestinal illness indicated by diarrhoea and/or vomiting using 14-day recalls among children and young adults. The study was set in Isiolo, a rural town of Kenya, inhabited mainly by pastoralists of different ethnic groups. The preparation methods of milk at the household level were also investigated. The study was cross-sectional and involved 900 participants from randomly selected households. They were interviewed using a structured questionnaire. An unmatched nested case-control study was constructed by randomly selecting three controls for each case. Potential risk factors for gastrointestinal illness were analysed using both univariate and multivariate logistic regression models with random effect on ethnic groups. The study results showed that consumption of mutton, carrots, Irish potatoes, raw camel milk, boiled camel milk and fermented camel milk were important risk factors for diarrhoea and/or vomiting, whereas the consumption of boiled goat milk, boiled cow milk, spinach, washing of hands with soap and the presence of proper drainage system had protective effects (odds ratio < 1). We conclude that in this setting, primarily vegetables and the camel milk market chain pose the greatest risks for symptoms of food-borne gastrointestinal illness.