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- Volume 19, Issue 4, 2006
South African Journal of Clinical Nutrition - Volume 19, Issue 4, 2006
Volumes & issues
Volume 19, Issue 4, 2006
The need for context-specific nutrition and health policies and interventions : the reality of disparities in socio-economic, health and nutritional statusAuthor Muhammad A. DhansaySource: South African Journal of Clinical Nutrition 19, pp 142 –145 (2006)More Less
During discussions with local health professionals pre-1994, Dr Urban Johnsson of UNICEF was told that, unlike Malawi, South Africa was a heterogeneous country. Interventions proposed by UNICEF needed to take into consideration differences that existed between and within regions in the country, with regard to health and socio-economic status.
Source: South African Journal of Clinical Nutrition 19, pp 146 –151 (2006)More Less
Background. Child undernutrition is a significant public health problem in Malawi.
Objective. To determine the localisation of underweight, stunting and wasting in three main agricultural development divisions (ADDs) in Malawi.
Design. Descriptive population-based cross-sectional study.
Setting. Rural subsistence farming communities in Mzuzu, Lilongwe and Blantyre ADDs.
Subjects. Children aged 6 - 59.9 months.
Outcome measures. Anthropometric measurements were taken to determine the mean weight-for-age z-scores (WAZ), height-for-age z-scores (HAZ) and weight-for-height z-scores (WHZ). The prevalences of underweight, stunting and wasting were also determined.
Results. The mean WAZ of children from Mzuzu ADD was significantly higher than that of children from Lilongwe ADD (-1.04 v. -1.43, p = 0.001) and Blantyre ADD (-1.04 v. -1.32, p = 0.03). Similarly, children from Mzuzu ADD had significantly higher WHZ than their counterparts from Lilongwe (0.22 v. -0.04, p = 0.021) and Blantyre ADDs (0.22 v. -0.09, p = 0.003). There were no significant between-group differences in mean HAZ (F = 2.73, p = 0.07). The prevalence of underweight was significantly lower in Mzuzu ADD (16.9%) than Blantyre (25.3%) and Lilongwe (31.3%) ADDs ( χ2 = 11.95, p = 0.003). Likewise, stunting was significantly lower in Mzuzu ADD (46.6%) than Blantyre (53.8%) and Lilongwe (61.3%) ADDs ( χ 2 = 8.71, p = 0.013). There were no differences in the prevalence of either stunting or underweight between Lilongwe and Blantyre ADDs.
Conclusion. The differences in prevalence of malnutrition among preschool children in the three agro-ecological zones may result from differences in ecological, demographic, social, economic and other pressures that these populations are exposed to. As Malawi decentralises most of its public services, there is a need for nutrition and health managers in specific areas to formulate uniquely localised programmes to deal effectively with the gravity and presumed diverse causes of nutrition problems. Some blanket national interventions are less likely to help in addressing local problems.
Source: South African Journal of Clinical Nutrition 19, pp 154 –160 (2006)More Less
Objectives. To design a semi-quantitative food frequency questionnaire (FFQ) to estimate peanut consumption during pregnancy, and to determine reproducibility when this consumption was recalled after a 2-year period.
Methods. An FFQ that lists commonly consumed peanut-containing products was developed. This was completed by a group of pregnant women, relating to their current diet (initial recall). Two years later the same women were asked to complete the same FFQ with reference to the period of their pregnancy (follow-up recall).
Results. A total of 30 women completed both the initial and follow-up questionnaires. Follow-up recall was found to be an unbiased estimate of initial recall, with a correlation coefficient of 0.95. Confidence intervals were defined to allow prediction of the initial recall value from the follow-up recall value.
Conclusion. Using our FFQ, retrospective recall of peanut consumption during pregnancy correlated well with data collected at the time. This FFQ will, when validated, provide a useful tool for investigating the role of maternal peanut consumption in later development of peanut allergy in children.
Stunting among young black children and the socio-economic and health status of their mothers / caregivers in poor areas of rural Limpopo and urban Gauteng - the NutriGro StudySource: South African Journal of Clinical Nutrition 19, pp 163 –170 (2006)More Less
Objectives. To determine the prevalence and immediate and underlying causes of stunting in black children aged 12 - 24 months living in rural and urban South Africa.
Design. A cross-sectional survey.
Setting. Two poor rural villages in Limpopo and two poor urban informal settlement areas in Atteridgeville, Gauteng. Population. All households with mothers / caregivers (M/Cs) of children aged 12 - 24 months in the selected areas. All households meeting the inclusion criteria in the urban areas (N = 380) and in the two rural villages (N = 156) were included in the sample.
Methods. Trained interviewers collected data using a standardised socio-demographic questionnaire. Heights and weights of M/Cs and their children were measured. Stunting was defined as a z-score less than -2 for height for age. Body mass index (BMI) values were calculated for the M/C. Data were analysed using a stepwise logistical regression analysis.
Results. A stunting rate of 18% was documented in the rural areas, with a difference of 8% between the two villages, and 19% in the urban areas. Statistically significant associations were found between low birth weight and stunting (p = 0.0073). Households with stunted children were significantly larger than households with non-stunted children (p = 0.0156). Stunted children were introduced to solid foods significantly earlier than non-stunted children (p = 0.0415).
Conclusions and recommendations. Similar prevalences of stunting were found in the urban and rural areas. Of the multifactorial causes of stunting, low birth weight, early complementary feeding and large household size were significantly associated with stunting. The data collected during this phase of the NutriGro Study will be the focus for all future community-based nutrition interventions.