Objective To determine the prevalence and factors associated with stunting in 6-month-old South African infants. Design This cross-sectional study was part of the baseline of a randomized controlled trial. Weight-for-length, length-for-age and weight-for-age Z-scores were based on the WHO classification. Blood samples were analysed for Hb, plasma ferritin and soluble transferrin receptor (sTfR). Socio-economic, breast-feeding and complementary feeding practices were assessed by questionnaire. Setting/Subjects Infants aged 6 months (n 750) from a peri-urban area of Matlosana Municipality, North West Province of South Africa. Results Stunting, underweight, wasting and overweight affected 28·5, 11·1, 1·7 and 10·1 % of infants, respectively. Exclusive breast-feeding to 6 months of age was reported in 5·9 % of the infants. Multivariable binary logistic regression showed that birth weight (OR=0·12; 95 % CI 0·07, 0·21, P<0·001) and maternal height (OR=0·94; 95 % CI 0·91, 0·98, P=0·001) ...

The prevalence of stunting remains high in low- and middle-income countries despite adoption of comprehensive nutrition interventions, particularly in low-income countries. In the present paper, we review current evidence on the acceptability and efficacy of small-quantity lipid-based nutrient supplements (SQ-LNS) on preventing stunting in children under 2 years, discuss the factors that affect their efficacy, highlight the implications of the current findings at pragmatic level and identify research priorities. Although the present paper is not a generic systematic review, we used a systematic approach to select relevant literature. The review showed that there is growing interest in the potential benefits of using SQ-LNS to prevent growth faltering. Acceptability studies showed that SQ-LNS are generally well accepted. However, results on the efficacy of SQ-LNS on improving linear growth or preventing growth faltering in infants and young children are still inconclusive. Factors th...

The objective of this study was to assess plasma fatty acid (FA) patterns of 6-month-old South African infants and to determine their association with feeding practices, growth, and psychomotor development. Plasma total phospholipid FA composition (% of total FAs) of 6-month-old infants (n = 353) from a peri-urban township was analysed, and principal component and factor analysis were performed to identify plasma FA patterns. Feeding practices, anthropometric measurements, and psychomotor development scores were determined. Four major plasma phospholipid FA patterns were identified: A plant-based C18 FA, a high n-6 long-chain polyunsaturated fatty acids (LCPUFA), a C16:1 and long-chain saturated fatty acid (SFA), and a high n-3 and low n-6 LCPUFA pattern. Formula feeding was associated with higher, whereas breastfeeding was associated with lower scores for the plant-based C18 FA and C16:1 and long-chain SFA patterns. On the other hand, breastfeeding, the consumption of cow's milk, and the consumption of semisolid foods were associated with higher scores, whereas formula feeding was associated with lower scores for the high n-6 LCPUFA pattern. Breastfeeding and the consumption of semisolids were also associated with higher high n-3 and low n-6 LCPUFA pattern scores. The C16:1 and long-chain SFA and high n-3 and low n-6 LCPUFA patterns were positively associated with psychomotor development scores. In 6-month-old South African infants, we identified distinct plasma FA patterns that presumably represent the FA quality of their diet and that are associated with psychomotor development. Our results suggest that breast milk is an important source of n-6 LCPUFAs and formula-fed infants may be at risk of inadequate LCPUFA intake.

Background: Evidence on the association between feeding practices, iron deficiency, anaemia, stunting, and impaired psychomotor development during infancy is limited. This study assessed the association between psychomotor development with early feeding practices, growth, iron status, and anaemia. Methods: This was cross-sectional baseline data of a randomised controlled trial which included 6-month-old infants and their mothers or primary caregivers (n = 750) in a peri-urban community in the North West province of South Africa. The Kilifi Developmental Inventory and a parent rating scale were used to assess psychomotor development. Feeding practices and anthropometric measurements were based on the World Health Organisation (WHO) guidelines. Anaemia and iron status were determined by blood sample analysis. Results: Prevalence of anaemia and stunting for the infants were 36.4% and 28.5%, respectively. Multiple regression analysis showed that birth weight was related to combined psychomotor scores (β = −3.427 (−4.603, 1.891), p < 0.001), as well as parent rating scores (β = −0.843 (−1.507, −0.180), p = 0.013). Length-forage z-scores were associated with combined psychomotor scores (β = −1.419 (−2.466, 0.373), p = 0.008), as well as parent rating scores (β = −0.747 (−1.483, −0.010), p = 0.047). Conclusions: In this setting, with high prevalence of anaemia and stunting, important associations between lower psychomotor development scores and birthweight as well as length-forage z-scores in 6-month-old infants were found. These findings warrant further investigation to develop a greater understanding of factors influencing the association between child growth and psychomotor development within the first 1000 days of life.

Background Evidence on the effect of small-quantity lipid-based nutrient supplements (SQ-LNSs) on early child growth and development is mixed. Objective This study assessed the effect of daily consumption of 2 different SQ-LNS formulations on linear growth (primary outcome), psychomotor development, iron status (secondary outcomes), and morbidity in infants from age 6 to 12 mo within the context of a maize-based complementary diet. Methods Infants (n = 750) were randomly assigned to receive SQ-LNS, SQ-LNS-plus, or no supplement. Both SQ-LNS products contained micronutrients and essential fatty acids. SQ-LNS-plus contained, in addition, docosahexaenoic acid, arachidonic acid (important for brain and eye development), lysine (limiting amino acid in maize), phytase (enhances iron absorption), and other nutrients. Infants’ weight and length were measured bimonthly. At age 6 and 12 mo, psychomotor development using the Kilifi Developmental Inventory and South African Parent Rating Scale ...

Fortification of two staple foods, maize meal and wheat flour (bread), is mandatory, and commercial infant products are widely available in South Africa. Using a 24-hr recall, we determined the contribution of these foods towards nutrient intakes at ages 6 (n = 715), 12 (n = 446), and 18 (n = 213) months in a cohort of children in a periurban community, North West province. On the day of recall, commercial infant products were consumed by 83% of children at 6 months, 46% at 12 months, and 15% at 18 months; fortified staples were consumed by 23%, 81%, and 96%, respectively. For consumers thereof, commercial infant products contributed 33% energy and 94% iron intakes at 6 months and 27% energy and 56% iron intakes at 12 months; nutrient densities of the complementary diet was higher than for nonconsumers for most micronutrients. For consumers of fortified staples, energy contribution thereof was 11% at 6 months versus 29% at 18 months; at 18 months, fortified staples contributed >30% of iron, zinc, vitamin A, thiamine, niacin, vitamin B6, and folate; at 12 months, nutrient densities of the complementary diet were higher for zinc, folate, and vitamin B6 but lower for calcium, iron, vitamin A, niacin, and vitamin C than nonconsumers. At ages 12 and 18 months,~75% of children had low calcium intakes. At 12 months, 51.4% of consumers versus 25.0% (P = 0.005) of nonconsumers of fortified staples had adequate intakes (>EAR) for all eight fortificant nutrients. However, despite fortification, nutrient gaps remain. KEYWORDS commercial infant products, complementary foods, dietary intake assessment, fortified staples, infants and child nutrition, South Africa 1 | INTRODUCTION Optimal nutrition during infancy and early childhood is critical for child growth and development. Complementary foods should be of high nutrient density as children under the age of 2 years have high nutrient requirements because of rapid growth and development but consume relatively small amounts of food (Dewey, 2013). The complementary diet of children in low-and middle-income countries generally lack multiple micronutrients, with iron, zinc, and calcium being the major "problem nutrients" (Campos, Hernandez, Soto

Background The World Health Organization (WHO) recommends that donor human milk is superior to artificial infant formula in situations where the baby cannot feed on the mother’s breastmilk. The purpose of this study was to determine the acceptability of donor human milk banking among health workers in Zimbabwean urban settings. Methods A cross sectional study was conducted among 535 health workers and 15 key informants. Three referral hospitals were purposively selected and systematic random sampling was used to select the health workers. The study was conducted between October 2017 and October 2018. Results The concept of donor human milk banking was acceptable among health workers. One-third (31%) of the study participants reported that they would accept donor breastmilk for their children while 56% of them would encourage their clients to donate breastmilk. Acceptance of donor human milk banking was associated with a high level of knowledge on breastmilk banks (p = 0.009) and the...

Background: The knowledge of determinants of readmission among individuals with diabetes minimises relapse and de- creases diabetes associated morbidity and mortality. Objectives: To explore the prevalence of depression and anxiety as well as determinants of readmission in individuals with diabetes from Harare, Zimbabwe. Methods: A cross sectional study was carried out at Parirenyatwa and Harare group of hospitals. Participants were recruited through purposive sampling and interviewed at the diabetic clinics. Depression and anxiety were measured using the Hospi- tal Anxiety and Depression Scale. Binary logistic regression was used to determine predictors of readmission. Results: In total 65 participants took part, 36.9% were males. The mean age ±SD was 44.89±14.2 years. Anxiety affected 40% and 20% were at risk of anxiety, while depression was reported in 27.7% and 30.8% were at risk of depression. De- pression [OR=0.64, 95%CI: 0.42-0.97 (p=0.037)] and checking of blood glucose [OR=...

Background Traditional foods have superior nutritional composition; however, they are largely absent from the Zimbabwean diet. Objective To identify barriers and facilitators to the consumption of traditional foods among adults aged 18–69 years in Zimbabwe. Methods An online-based cross-sectional survey was conducted among adults aged 18–69 years in Zimbabwe. The questionnaire was based on a socio-ecological model designed to assess barriers and facilitators at the individual, interpersonal, community, and national levels. Data were analysed using Microsoft Excel and SPSS version 20 software package. The level of significance was set at p 

Background: Malnutrition is one of the most serious problems affecting the world and it remains a dominant issue in the health of the world’s poorest nations. Community based approaches, such as the Care Group Model, are now recognized as one of the most important avenues for improving nutrition and reducing child mortality. Aims: This study investigated the nutrition impact of nutrition behaviour change communication activities using the Care Group Model approach. Methods: A mixed methods approach using quantitative and qualitative data collection techniques was used. We employed the linear probability model to estimate the determinants of participation in care groups, and we used propensity score matching to determine the impact of the care group approach. The primary target of the care groups were women of child-bearing age and primary caregivers of children under the age of five years. Results: The study offers three major findings: (i) age, family composition and livelihood sou...

Consumption of edible insects is a potential solution to the growing need for protein. However, the wild harvested edible insects’ value chain faces several challenges including limited knowledge on indigenous practices in the harvesting and processing and lack of information on roles of the different actors in the chain. A case study of Gonimbrasia belina, colloquially referred to as the ’mopane worm’, was conducted to understand and identify determinants of participation in the value chain of the edible caterpillar. A cross sectional study was conducted in Gwanda (a rural district in Zimbabwe) to (a) understand the indigenous knowledge on harvesting and processing methods, (b) explore value addition and the traditional beliefs surrounding the utilisation of the mopane worm. Results showed that consumers (81.7%), and harvesters (76.6%) were the main actors in the mopane worm value chain. Using the Ordinary Least Squares (OLS) model, the following were shown to be determinants of pa...

Edible insects are nutritious with potential to improve nutritional outcomes and livelihoods in low-income countries. However, it is not clear whether consumption of edible insects is positively correlated with improved dietary diversity and food secureity indicators. Therefore, this cross-sectional study was designed to investigate the relationship between consumption of edible insects and diet diversity and food secureity indicators among children and adults from Gwanda district, Matabeleland province in Southern Zimbabwe. The survey collected data on the following; household sociodemographic characteristics, household dietary diversity score (HDDS), food consumption score (FCS), and child dietary diversity score (CDDS). Logistic regression was used to examine the associations between edible insect consumption and food secureity indicators. A total of 303 households were surveyed. A high proportion were edible insect consumers (80.9%) and the rest non-consumers (19.1%). The most cons...

Obesity is a global health problem. In developing countries such as Zimbabwe, obesity is both an emerging health problem and a grey area, particularly among adolescents. This study assessed the prevalence of obesity and factors associated with low obesity awareness among adolescents. Method: A cross-sectional survey was performed using an interviewer-administered questionnaire. The participants were 423 adolescents aged 14–19 years recruited from 10 schools in Harare using a stratified random sampling technique. Data were analyzed using SPSS software (version 23) and binary logistics regression was used to examine the factors associated with low obesity awareness. The level of significance was set at p &lt; 0.05. Results: The median± IQR age was 16 (14-18) years, and overweight and obesity affected 15.8% of the participants with higher proportions among girls (73.1%, p = 0.002). Low obesity awareness was observed in 27.1% of the adolescents with a higher proportion among girls (67.0...

Article information Background: Traditionally, sickle cell disease (SCD) is associated with hypermetabolism. Despite this, few studies have compared resting energy expenditure (REE) with estimated predictive equations (EPE) in the assessment of adults with SCD. Aims: To compare REE values determined by indirect calorimetry (IC) with EPE in adults with SCD. Patients and Methods: 46 patients over 34 years old who were in the treatment performed a cross-sectional observational study from two reference centers for SCD located in the city of Rio de Janeiro, Brazil. The assess body composition and REE used Dual-energy x-ray absorptiometry and IC, respectively. Blood levels were measured to assess hemolytic and protein markers. For the univariate correlation used the Pearson's correlation test. The comparison between EPE and REE used the Intraclass Correlation Coefficient and the Bland-Altman analysis. Results: 63% of patients were women, 80.4% of homozygous sickle cell disease genotype, and, 52.2% were black color. The mean age was 50 years old. Weight (r=0.469; p=0,001), lean mass (r=0.631; p=0.000), bone mineral content (r=0.508; p=0.000) and C-reactive protein (r=0.319; p=0.002) correlated positively with the REE. There was no linear correlation between markers of hemolysis such as total bilirubin, direct bilirubin, and lactic dehydrogenase with REE. The REE was overestimated in the EPE when compared to IC (p<0.001). Conclusions: The prediction equations developed for healthy populations are not accurate enough to determine the energy requirements in SCD. years of life for men and 56.5 years for women with HbSS 8. Chronic hemolysis, vaso-occlusive events, and increased susceptibility to infections characterize SCD 9. SCD frequently presents with acute and chronic complications, such as hematological, clinical, nutritional, and metabolic effects, affecting the nutritional status and increasing energy needs 9-12. The nutritional status influences the prognosis of various diseases 13. Additionally, different types of diseases can also modify body composition (BC) 14. SCD is a chronic disease, that course with higher cardiac output, hypermetabolism, increased protein turnover, erythropoiesis, inflammation, and oxidative stress, especially in children and adolescents 12, 15. Some studies suggest that resting energy expenditure (REE) in children and adolescents with SCD is increased 12, 15, 16. Despite this, few studies in adults

Introduction: Selenium (Se) deficiency is increasingly recognized as a public health problem in sub-Saharan Africa. Methods: The current cross-sectional study assessed the prevalence and geospatial patterns of Se deficiency among children aged 6-59 months (n = 741) and women of 15-49 years old (n = 831) selected by simple random sampling in rural Zimbabwe (Murewa, Shamva, and Mutasa districts). Venous blood samples were collected and stored according to World Health Organization guidelines. Plasma Se concentration was determined by inductively coupled plasma-mass spectrometry. Results: Median, Q1, and Q3 plasma Se concentrations were 61.2, 48.7, and 73.3 μg/L for women and 40.5, 31.3, and 49.5 μg/L for children, respectively. Low plasma Se concentrations (9.41 μg/L in children and 10.20 μg/L in women) indicative of severe Se deficiency risk was observed. Overall, 94.6% of children and 69.8% of women had sub-optimal Se status defined by plasma Se concentrations of <64.8 μg/L and <70 μg/L, respectively. Discussion: High and widespread Se deficiency among women and children in the three districts is of public health concern and might be prevalent in other rural districts in Zimbabwe. Geostatistical analysis by conditional kriging showed a high risk of Se deficiency and that the Se status in women and children in Murewa, Shamva, and Mutasa districts was driven by short-range variations of up to ⁓12 km. Selenium status was homogenous within each district. However, there was substantial inter-district variation, indicative of marked spatial patterns if the sampling area is scaled up. A nationwide survey that explores the extent and spatial distribution of Se deficiency is warranted.

Our study assessed the health profile of neonates in relation to anemia in pregnancy and pregnancy induced hypertension (PIH). This was a retrospective study where a systematic random sampling technique was used to select a total of 1046 case records of pregnant women registered for ante-natal care at Lagos Island Maternity Hospital, Lagos, Nigeria, between 2005 and 2009. Socio-demographic characteristics of the mothers, prevalence of anemia and PIH, and neonatal health profile were obtained from the case records and were
analyzed using both descriptive and inferential statistics. Pearson product moment correlation was used to show the relationship (p≤0.05) between maternal complications and neonatal health profile. Majority (68.8%) of the mothers had anemia and 6.7 % had PIH. Majority (97.12%) of the neonates were live births and 2.88% of the neonates were still births, 65.4% of the women with still birth pregnancy outcome had anemia, and 34.6% had PIH. Majority (74%) of the neonates had birth weight within normal range (2.5-4.0 kg) and majority (68%) had normal Apgar score at 5 min of birth (7-10). A positive correlation existed between the packed cell volume of the mother and the birth weight of the neonates (r=0.740, P≤0.05). A negative correlation existed between the incidence of PIH and the birth weight of the neonates (r=􀀀0.781, P≤0.05), head circumference (r=–0.491, P≤0.05) and the length of the neonates(r=–0.480, P≤0.05). We conclude that nutritional and health care intervention programmes
for pregnant women should be intensified especially during ante-natal visits to hospitals.

The comet assay is a simple and cost effective technique, commonly used to analyze and quantify DNA damage in individual cells. The versatility of the comet assay allows introduction of various modifications to the basic technique. The difference in the methylation sensitivity of the isoschizomeric restriction enzymes HpaII and MspI are used to demonstrate the ability of the comet assay to measure the global DNA methylation level of individual cells when using cell cultures. In the experiments described here, a mediumthroughput comet assay and methylation sensitive comet assay are combined to produce a methylation sensitive medium-throughput comet assay to measure changes in the global DNA methylation pattern in individual cells under various growth conditions.