Research Articles (Human Nutrition)
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- ItemGastrointestinal symptoms in HIV-positive kidney transplant candidates and recipients from an HIV-positive donor(Nature, 2021-06) Martin, C. J.; Veldman, F. J.; Labadarios, Demetre; Ebrahim, Z.; Muller, E.; Kassier, S. M.Gastrointestinal symptoms (GIS) are common in kidney transplant candidates and recipients and may be worsened by HIV. Objective: To determine the frequency and severity of GIS in HIV-positive kidney transplant recipients from HIV-positive donors, and those waiting to receive one. A GIS rating scale (GSRS) was completed by 76 participants at baseline and at 6 months. GIS frequency was defined as having at least one symptom (GSRS > 1). Severity was indicated by the GSRS score. Transplant candidates: GIS frequency was 88.9% and 86.3% at baseline and 6 months respectively. Indigestion was the most frequent (79.6% and 66.7% at baseline and 6 months), and severe GIS (GSRS 2.3). Women reported global mean (p = 0.030) severity significantly more than men. Transplant recipients: GIS frequency was 95.2% and 76.2% at baseline and 6 months respectively. At both assessment points, indigestion occurred most frequently (85.7% and 61.9% respectively). Highest GSRS was reported for indigestion at baseline (2.33) and at 6 months (1.33). Waist circumference (WC) was positively associated with the severity of constipation GSRS. GIS are common in both groups, especially indigestions. WC in transplant recipients should be monitored.
- ItemDIETARY PATTERN, HOUSEHOLD HUNGER, COPING STRATEGIES AND NUTRITIONAL STATUS OF CHILDREN IN SEKHUKHUNE DISTRICT OF LIMPOPO PROVINCE, SOUTH AFRICA(2020-05) Mbhenyane, Xikombiso GertrudeGlobally, approximately one out of every nine people do not get enough food to eat. The situation is more persistent in the sub-Saharan region of Africa with an estimated 23.2% of the population experiencing food deprivation. The aim of this study was to determine the dietary pattern, prevalence of hunger, the association between household hunger and nutritional status of children under 12 years, and the coping strategies that mothers use to adapt to periods of food deprivation in their households in Sekhukhune district. An analytical study design was used. A structured, interviewer-administered questionnaire was used to survey mothers/caregivers and their children from 180 households selected from nine villages by means of systematic random sampling. Anthropometric measurements were used to determine caregivers and children’s nutritional status. Statistical Package for Social Sciences (SPSS) version 20 was used to analyse the collected data. Descriptive and inferential (Chi-square (χ2) test) statistics were used. The results indicated that the main food items consumed by most children were mealie/maize meal, sugar, tea, iodised salt, bread, and meat. The findings revealed that 44.4% of households were food insecure, whereas 33.9% were at risk of hunger, and only 21.7% were food secure. The main coping strategies used were borrowing food from neighbours, family or friends, and borrowing food from the local shops. Anthropometric indices were associated with food availability and the utilisation of coping strategies such as sending children to neighbours asking for food, credit from local shops, reducing food portions, or even sometimes sending children to bed hungry (p<0.05). About four to five out of ten children sometimes go to bed hungry. Households borrowing food from neighbours, family or friends, and credit from the local shop were the most common coping strategies. The need for nutrition education on low cost nutritious diets and sustainable food programmes intervention strategies are required in Sekhukhune District. In addition, positive response modes for coping with food deprivation, such as the use of wild foods and livestock should be encouraged.
- ItemSocioeconomic determinants influencing nutritional status of children in Sekhukhune District of Limpopo Province in South Africa(Avens Publishing Group, 2019) Phooko-Rabodiba, D. A.; Tambe, B. A.; Nesamvuni, C. N.; Mbhenyane, Xikombiso G.South Africa has adequate food supplies to feed the entire population at national level. However, reports have shown evidence of under-nutrition among certain parts of the population due to lack of access. The aim of the study was to determine the relationship between socioeconomic status of the household and the nutritional status of children one to twelve years (1-12 years) in Sekhukhune district of Limpopo Province. The study used exploratory designs. A structured interviewer-led questionnaire was used to determine socio-economic parameters and standard anthropometric procedures. All analyses were done using Statistical Package for Social Sciences version 20. A total number of 180 mother-child pairs participated in the study. The sample distribution for children was 46.1% male and 53.9% females. Most mothers were unemployed and spent less than 500.00 ZAR (≈50 USD) per month to purchase food for the household. There was a high (39.6%) prevalence of stunting among children under the age of 60 months, a medium prevalence of underweight, and a low prevalence of wasting in all children. Most caregivers were overweight or obese. Maternal level of education and household income was significantly associated with anthropometric status indicators (p<0.05). This study revealed a high rate of unemployment, poor household income and purchasing power, and high level of food insecurity. This might have contributed to the high prevalence of stunting and a medium prevalence of underweight recorded in the study. There is urgent need to address basic needs to improve access to nutrient rich foods and health care.
- ItemIodine status of pregnant women and children age 6 to 12 years feeding from the same food basket in Mopani district, Limpopo province, South Africa(MedPharm Publications, 2019-03-23) Mabasa, E.; Mabapa, N. S.; Jooste, P. L.; Mbhenyane, Xikombiso G.Objectives: The aim of the study was to assess the iodine status of pregnant women and children age 6 to 12 years feeding from the same food basket in Mopani District. Design: A cross-sectional study was conducted. Setting: The setting was primary health care clinics and households from five municipalities of Mopani District in Limpopo province. Subjects: A total of 565 conveniently selected pregnant women and 116 children aged 6 to 12 years were recruited, of which 116 were mother–child pairs. Methods: The demographic information, iodine nutrition knowledge and salt consumption patterns were obtained using a validated questionnaire. Spot urine, household drinking water and salt samples were collected and analysed for iodine using standard procedures. A professional nurse, using filter paper to determine thyroid stimulating hormone (TSH) levels, collected spot finger-stick blood samples from pregnant women. Results: The findings showed that only 52.5% of household salt had an iodine concentration level of more than and equal to 15 ppm. The median iodine concentration of household drinking water was 46.2 μg/l (interquartile range [IQR] 10.8–73.4 μg/l). The TSH levels of the majority of pregnant women were normal and the maternal overall median urinary iodine concentration (UIC) was 164 μg/l (IQR 92–291 μg/l), indicating maternal iodine sufficiency. However, median UIC in the first and third trimesters was below 150 μg/l, indicating iodine insufficiency. The UIC level of children in the study was 386 μg/l (IQR 200–525 μg/l), signifying iodine excess. Conclusion: Iodine status of pregnant women in this study was sufficient, with UIC for children excessively high, more than two times higher than the iodine status of pregnant women. The reasons for the excessive UIC in school-age children need to be elucidated.
- ItemSeasonality in associations between dietary diversity scores and nutrient adequacy ratios among pregnant women in rural Malawi – a cross-sectional study(Swedish Nutrition Foundation, 2019) Hjertholm, Katrine G.; Holmboe-Ottesen, Gerd; Iversen, Per O.; Mdala, Ibrahimu; Munthali, Alister; Maleta, Kenneth; Shi, Zumin; Ferguson, Elaine; Kamudoni, PenjaniBackground: Dietary diversity scores (DDS) are simple indicators often used as proxies for nutrient adequacy. A 10-food group indicator is proposed by the Food and Agriculture Organization of the United Nations as a global standard for measuring dietary diversity among women in low-resource settings. However, its validity as a proxy for nutrient adequacy across different agricultural seasons for pregnant women has not been determined. Objective: We studied associations between DDS and nutrient adequacy ratios (NAR) across two different agricultural seasons (pre- and post-harvest seasons) for pregnant women in rural Malawi and assessed whether a 1-day DDS or a 3-day DDS would be the best indicator of nutrient adequacy. Design: Dietary intakes of 330 pregnant women were assessed between gestational weeks 28 and 35. Intakes of energy, macronutrients, and 11 micronutrients were estimated using three repeated interactive 24-h diet recalls, and DDS were also calculated from these days. Correlation coefficients (r) between DDS, NAR, and mean adequacy ratio (MAR) of the 11 micronutrients were determined. Results: After energy adjustments, we found significant correlations between DDS and MAR with both DDS indicators in the preharvest season (r = 0.22–0.23; p < 0.001) but not in the post-harvest season (p > 0.05). For individual energy-adjusted NARs, correlations were not consistently significant across the two seasons and the two DDS indicators. Conclusions: Our results suggest that DDS could be used to predict overall nutrient adequacy during the preharvest season. As similar correlations were found using both the 1- and 3-day indicators, we recommend using a 1-day DDS, for simplicity. However, as the indicators are sensitive to seasonality they should be used with care in this study setting.