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- Volume 23, Issue 1, 2010
South African Journal of Clinical Nutrition - Volume 23, Issue 1, 2010
Volumes & issues
Volume 23, Issue 1, 2010
Author Haroon SaloojeeSource: South African Journal of Clinical Nutrition 23, pp 7 –8 (2010)More Less
The paper by Schoeman et al published in this issue of the SAJCN makes for bleak reading. The picture presented is of under-resourced rural clinics, lacking basic facilities such as water and toilets (never-mind telephones), with poorly trained staff who considered themselves overworked, and who believed that the solution to many of the prevalent childhood conditions was caregiver education, but evidently expended little effort offering any. The population of parents and caregivers served consisted largely of poor, single unemployed women claiming limited home food security, yet almost half were overweight or obese. Although the study is dated (conducted in 2003), many of its findings are likely to be as valid today.
Author A. PrinsSource: South African Journal of Clinical Nutrition 23, pp 11 –18 (2010)More Less
Nutritional status screening, assessment and monitoring is essential in the critically ill patient to reduce morbidity and mortality and to decrease hospitalisation costs. We in South Africa should establish where we are in terms of hospital-acquired malnutrition, perform a gap analysis and define a strategy to correct our shortcomings. We need to set a mission and vision for where we want to be. Elements to be addressed will include promoting a greater awareness of the negative consequences of existing and acquired malnutrition in the critically ill patient introducing an appropriate screening tool(s) based on our local patient demographics and financial resources, and sensitise the relevant role players. Adequate nutrition is a vital part of successful treatment, and should be sold as such.
Primary health care facility infrastructure and services and the nutritional status of children 0 to 71 months old and their caregivers attending these facilities in four rural districts in the Eastern Cape and KwaZulu-Natal provinces, South Africa : original researchSource: South African Journal of Clinical Nutrition 23, pp 21 –27 (2010)More Less
Objective: To assess primary health care (PHC) facility infrastructure and services, and the nutritional status of 0 to 71-month-old children and their caregivers attending PHC facilities in the Eastern Cape (EC) and KwaZulu-Natal (KZN) provinces in South Africa.
Design: Cross-sectional survey.
Setting: Rural districts in the EC (OR Tambo and Alfred Nzo) and KZN (Umkhanyakude and Zululand).
Subjects: PHC facilities and nurses (EC: n = 20; KZN: n = 20), and 0 to 71-month-old children and their caregivers (EC: n = 994; KZN: n = 992).
Methods: Structured interviewer-administered questionnaires and anthropometric survey.
Results: Of the 40 PHC facilities, 14 had been built or renovated after 1994. The PHC facilities had access to the following: safe drinking water (EC: 20%; KZN: 25%); electricity (EC: 45%; KZN: 85%); flush toilets (EC: 40%; KZN: 75%); and operational telephones (EC: 20%; KZN: 5%). According to more than 80% of the nurses, problems with basic resources and existing cultural practices influenced the quality of services. Home births were common (EC: 41%; KZN: 25%). Social grants were reported as a main source of income (EC: 33%; KZN: 28%). Few households reported that they had enough food at all times (EC: 15%; KZN: 7%). The reported prevalence of diarrhoea was high (EC: 34%; KZN: 38%). Undernutrition in 0 to younger than 6 month-olds was low; thereafter, however, stunting in children aged 6 to 59 months (EC: 22%; KZN: 24%) and 60 to 71 months (EC: 26%; KZN: 31%) was medium to high. Overweight and obese adults (EC: 49%; KZN: 42%) coexisted.
Conclusion: Problems regarding infrastructure, basic resources and services adversely affected PHC service delivery and the well-being of rural people, and therefore need urgent attention.
African leafy vegetables consumed by households in the Limpopo and KwaZulu-Natal provinces in South Africa : original researchSource: South African Journal of Clinical Nutrition 23, pp 30 –38 (2010)More Less
Objectives: The objectives of this study were to determine the availability of, access to and nutrition-related uses of African leafy vegetables in rural and urban households; and to determine the β-carotene content of the dominant African leafy vegetable.
Design: The study consisted of a qualitative explorative phase (field walks, semi-structured interviews with key informants, focus group discussions) at two rural sites; and a quantitative household survey (questionnaire) at two rural and one urban site. Amaranth leaves were analysed for β-carotene content.
Setting and subjects: The household survey included households at a rural site in Limpopo province (n = 100); and a rural (n = 101) and urban (n = 391) site in KwaZulu-Natal province, South Africa.
Results: A variety of edible plants were identified during field walks at the two rural sites. Focus group discussions narrowed this down to ten plants at the rural Limpopo site and six at the rural KwaZulu-Natal site. The most popular leaves were amaranth (Amaranthus spp), spider plant (Cleome gynandra), wild watermelon (Citrullus lanatus) and blackjack (Bidens spinosa), consumed individually or mixed with other leaves. Rural households procured leaves mostly from the wild whereas urban households relied more on informal markets. In Limpopo, leaves were dried and stored for consumption during winter. KwaZulu-Natal households considered African leafy vegetables food for the poor. Leaves were boiled in salted water, or steamed and then fried in oil. Fried and boiled amaranth leaves contained 627 and 429 μg retinol activity equivalents/100 g respectively.
Conclusions: Availability of, access to and nutrition-related uses of African leafy vegetables are context-specific, with inter- and intraprovincial rural / urban differences. Information collected during small studies within a specific area can therefore not be generalised for the overall South-African population. Amaranth can potentially contribute significantly to vitamin A requirements of nutritionally vulnerable communities.
Breastfeeding policies and practices in health care facilities in the Western Cape Province, South Africa : original researchSource: South African Journal of Clinical Nutrition 23, pp 40 –45 (2010)More Less
The Baby-Friendly Hospital Initiative (BFHI) is a global effort to improve the role of maternity services and to enable mothers to breastfeed their infants, thus ensuring the best start in life for their infants. The foundation for the BFHI is the Ten Steps to Successful Breastfeeding (BF). It has been shown, however, that the selective implementation of only some of the steps may be ineffective and discouraging to successful BF practices. An initial study was therefore conducted to assess the extent of the implementation of the Ten Steps in both public and private maternity facilities. Poor performance for some steps led to a follow-up study to investigate the knowledge and attitudes of health care workers (HCWs) and mothers alike and to evaluate the exclusive BF (EBF) practices of mothers attending private BF clinics. Both studies followed descriptive, cross-sectional designs and were set in the Cape Metropole in the Western Cape. Twenty-six maternity facilities participated in the initial study, for which observation lists were completed and verified by interviewer-administered questionnaires to both HCWs and mothers. Eighteen private BF clinics participated in the follow-up study, which included observations and interviewer-administered questionnaires to 25 HCWs and 64 mothers. During the initial study, lower mean scores were noted for Steps 1, 2, 6 and 10. The overall implementation of the Ten Steps was average. The findings highlighted the importance of the establishment and implementation of BF policies, of appropriate and continuous BF training and better referral systems to ensure initiation and establishment of early BF, EBF practices and support on an ongoing basis to ensure the best start in life for infants.
Author C. MacDougallSource: South African Journal of Clinical Nutrition 23, pp 46 –47 (2010)More Less
The patient, a 79-year-old woman, was admitted to hospital on 14 August 2009 with locked jaws, generalised body pain and dyspnoea. She presented with features suggestive of tetanus, including trismus (prolonged tonic spasm of the muscles of the jaw), generalised rigidity and irregular muscle spasms. The patient had a medical history of type II diabetes mellitus and hypertension.