71 Records out of 22207 Records

Counsels on dietary norms and wellbeing of adherents : a case of Seventh-Day Adventist Church in Kericho District, Kenya

Author: Rop, Naaman

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Diet/Health/Religion/Seventh Day Adventist churches/Kericho District/ ;

Abstract:

This study aimed at answering what could be enabling the se'v~nth Day Adventists 111 Kericho District enjoy better well-being thus longevity than non-Seventh Day Adventists. T~,e study endeavored to show the relationship between Seventh Day Adventists' teachings. beliefs and practices to well-being. The study was also interested in finding out other factors that could be enhancing health amongst the Seventh Day Adventist. The extent of incorporation of the Seventh Day Adventists' teaching, beliefs and practices in the lives of the adherents was also analyzed. Since Adventists are known for the so called siecio! diet/health reform, tracing the historical development of the health reform amongs: Adventists was also investigated. The study employed case study research design since it aimed at analyzing Seventh Day A.dventists teachings, beliefs and practices in detail, context and in totality. The study else used the particular case of Seventh Day Adventist Churches in Kericho District. The study used questionnaires to collect primary data from key informants, ordinary members of the Churches and non-Seventh Day Adventists who neighbour the Church. In-depth interviews and focus group discussion were applied in the study too. In reporting the nndings of the study, descriptive approach was utilized. lhe study was based on the assumptions that the various components parts of a social group such as: teaching, beliefs and practices int1uence the total behavior of a particular social group Lor instance social, economic, and political and even lifestyle. The general systems theory associated with Buckeley (1967) was applied in the study, since the stud) aimed at explicating the people's representation of their teachings, beliefs and oractices in relation to health and general well-being. The study used non-probahility convenience sampling technique to identify the sample representing members of the Churches. nonprobabil.ity purposive sample for the key informants; leaders and random sampling for the n()11-Adventist informants, it was found that the Seventh Day Adventist teachings advice on dietary norms. It was also noted that to a very greater extend, the Seventh Day Adventist teachings on wellbeing have been incorporated into the lives of adherents. It was noted that the Kipsigis traditional culture had laid foundation which was later on continued by the Seventh Day Adventists counsels on healthful living; hence explaining the greater percentages of incorporation of the teachings in the lives of adherents.

Levels and determinants of nutritional status, knowledge and practices of adult Osteoarthritis patients : the case of Kikuyu Orthopaedic and rehabilitation centre, Kenya

Author: Wanjala, Zipporah Kiruthu

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nutrition/Diet/Adults/Osteoarthritis/Kikuyu Orthopaedic and Rehabilitation Centre/Diabetes/Hypertension/ ;

Abstract:

Osteoarthritis (OA) is the commonest condition that affects human beings; however, there is paucity of information in its management in Kenya and Africa at large. According to the Association of Arthritis and Rheumaac Disease of Kenya (AARD) there is sufficient evidence that arthritis is a growing burden in this country hence the need to improve quality of life of arthritis sufferers by empowering them to participate in their own care by being part of the treatment plan which involves medication, diet, weight management and physical activity. The objective of this study was to determine the nutritional status, knowledge and practices of adult OA patients. The study took place at Kikuyu Orthopedic and Rehabilitation Centre (KORC) in Kikuyu County from November 2011 to January 2012. A structured questionnaire was pretested and used to collect information on socio-economic demographics, nutritional knowledge, dietary diversity and level of physical activity. Anthropometric measurements of height and weight were used to calculate BMI and determine nutritional status of the patients. Focus Group Discussion guide and Key Informant interview guide were used to collect qualitative data. SPSS 16.0 and Ms-Excel 2007 software was used for statistical data analysis. A sample size of 205 OA patients was determined using the Fischer's formula. The study design was cross-sectional, descriptive and analytical in nature. Sampling procedure involved purposive sampling of KORC and exhaustive sampling method was used to select respondents. The respondents were aged between 18-74 years and 26.8 % were male while 73.2 % were female, 31.2 % of the respondents originated from Nairobi County and 30.7 % from Kiambu County. The study showed that more than two thirds (80.2 %) of the respondents hal low level of knowledge (scored 0 % to 40 %), 8.7 % correctly described a balance diet as die containing carbohydrates, proteins, fats, vitamins and minerals and 67 % described it a: adequate amount offood. Eighty six (86 %) of the respondents bad moderate dietary diversity score consuming between 4-8 food groups in a day. Fifty percent (50 %) of the respondents reported that they suffered from other diseases with 45 % suffering from hypertension and 25 % from diabetes mellitus. In conclusion, OA patients have low nutritional knowledge. Their daily dietary intake of fruits (30.7 %), eggs (7.3 %), milk and milk products (15.6 %) is low while that offish and sea foods (3.4 %) which are known to be rich in omega 3 and Vitamin D is extremely low. Majority of the patients are overweight or obese (71 %). Physical activity level is moderate while sedentary behavior mean time is 4.8 (?2.2) hours. Education level is related to nutritional status (r=O.360, p=O.014), knowledge (r=O.419, p=O.024) and dietary practices (r=O.539, p=O.002). There is a positive association between nutrition knowledge and dietary diversity (r=O.127) (p=O.04). Physical activity is related to nutritional status (X2=10.129, P=O.03). Approximately 42.9 % of the variance of nutritional status is accounted for by age, monthly income and education level. To improve patient's nutritional status and knowledge therefore there is need to educate the public on healthy habits such having a balanced diet and exercising. Nutritionists should work closely with OA patients in order guide then on appropriate diet, weight management and physical activity.

The potential role of nutrition education in reduction of overweight and the associated risk factors among school children (9-14 years) in Nairobi, Kenya

Author: Kyallo, Florence Mumbi Muthiani

Awarding University: University of Nairobi, Kenya

Level : PhD

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nutrition education/Diet/Obesity/Health risk assessment/Children and youth/Teenagers/Nairobi, Kenya ;

Abstract:

Obesity among children is increasing at an alarming rate worldwide, With research linking both childhood malnutrition and obesity to increased risk of morbidity and mortality in adulthood, more attention is now shifting to addressing the pandemic among children so as to alleviate the generational calamity in the future. This study investigated the prevalence of overweight, the associated risk factors and the potential of nutrition education as an intervention among school children aged 9-14 years attending private and public schools in Nairobi. From two randomly selected divisions, four schools, two public and two private, were randomly selected for inclusion in the study. At baseline, nutrition status of the children was determined using anthropometric indices. Dietary practices were assessed using the 24 hour dietary intake recall method. Sociodemographic characteristics and physical activity were collected using a pre-tested questionnaire. One public and one public school were randomly allocated into two study groups, an intervention (IG) and a control group (CG). Pupils in the IG received a nutrition education package while those in the CG did not receive the intervention. The children were followed up for eleven months (3 school terms) and assessments were carried out at the end of every school term. Data were analysed using WHO AnthroPlus, OpenEpi and SPSS version 17.0. Descriptive statistics were used to describe characteristics of the study children while inferential statistics were used to establish differences in various variables between the control and intervention groups, and relationships between selected variables and overweight. Chi-square tests and Odds Ratio (OR), were used to test relationships between categorical variables. Tvtests and MannWhitney U tests were used to compare continuous variables with normal distribution and those without normal distribution, respectively. The Wilcoxon test was used to compare trends in anthropometric characteristics throughout the study. A p value <0.05 was considered significant. Out of 344 study children, 40.4% were from private schools and 52.3% were female. The mean age of the children was 12.0?0.84 years, with 79.9% within age 11-12 years. The prevalence of obesity was 5.9%, while combined overweight and obesity was 19.0%, with prevalence in private schools significantly higher (29.0%) than public schools (11.5%). Prevalence was highest among girls in private schools (30.9%), followed by boys in private schools (27.1 %). Socio-dernographic and economic factors found to be positively associated with overweight included being in a private school, not having siblings, mother's occupation, type of residence, access to a family computer with computer games, having a personal cell phone, number of cell phones, use of motorised transport to and from school and time spent on sedentary activities after school. Dietary factors included consumption of margarine, white bread, githeri and sugar sweetened black tea/coffee. On the other hand, factors found to be negatively associated with overweight included having physical education ePE) scheduled in the class timetable, participation in physical education, active commuting to and from school, having family meals and receiving food rewards, consumption of vegetables, cake, maandazi and eggs. The predictors of overweight included being in a private school, having a self-employed mother, being a single child, having access to a family mobile phone and not having family meals. The intervention resulted in significant increase in participation in physical education (PE) and swimming, decrease in consumption of white bread, maandazi and crisps and an increase in consumption of wholemeal bread and fruits (p<O.05), but no significant decrease in overweight. In conclusion, the overweight rate in the study group is of public health concern. The school curriculum should be revised to include compulsory participation of all children

Diversity of food consumption by households and their exposure to aflatoxins from Maize products in Kibwezi District, Makueni County

Author: Kilonzo, Robert Musyoka

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Food contamination and poisoning/Diet/Food safety/Aflatoxins/Maize/Kibwezi District ;

Abstract:

Maize is the basic staple of the Kenyan diet. Ugali, a thick porridge of maize meal, is the main dish. Other maize based dishes include boiled mixture of maize and beans (githeri) which when the maize kernels are decorticated, is referred to as muthokoi, and cooked mash of maize, beans, vegetables and potatoes, referred to as irio. Other staple fO,ods include cereals like sorghum, millet, legumes, pulses and rice, cassava, sweet potatoes, fruits and vegetables. Milk and dairy products are also important items in the country, but especially among the pastoral communities. A wide variety of agricultural products worldwide, have been found to be contaminated by aflatoxins. Aflatoxicosis has repeatedly occurred Kenya. This study was designed to examine the consumption patterns of maize products and other foods in Kibwezi District and assess the exposure of households to aflatoxins through consumption of maize and maize products. Multi-stage sampling was used to select 72 households for the study from the three (3) divisions of the district with 24 households being randomly sampled from each division using a sampling interval of 2 households. A previously pretested structured questionnaire was used to collect data on the socio-demography of the household, diversity of foods consumed and the frequency of their consumption. Twenty samples, each of maize kernels, muthokoi and maize meal were randomly sampled from households in the three divisions of Kibwezi District. The samples were transported to the laboratory for aflatoxins analysis. Each sample was qualitatively screened for the presence of aflatoxins using Thin Layer Chromatography method and then the positive samples analyzed quantitatively for the toxins using High Performance Liquid Chromatography. Total aflatoxins exposure (ug/kg body weight (bw)/day) was determined from multiplying the average daily per capita maize and maize products consumption (kg) by the total aflatoxins level in maize and maize products (ug/kg). For each household the figure was divided by an average body weight of an adult of 60 kg. The results on socio-demography showed that the households had a total of 298 residents of which 45 % were males and 55 % females with an average family size of 4?1.3. Those aged below 5 years were 15 %, while those aged between 6 - 12 years and 13 - 18 years were 18 % and 12 % respectively. The results further showed that 9 % of the residents had attained college and university education while 20 % had completed secondary education. Those who had completed primary education only were 27 % and those without formal schooling were 9 % . Results on diversity of foods consumed revealed that 44 % of the respondents consume ugali seven times in a week, and about 10 % of the households consumed it more than ten times a week. Githeri was consumed seven times a week by 35 % of the families. Consumption of muthokoi was once a week by 25 % of the families, and porridge was consumed seven times by 21 % of the families. Of the other foods, the most commonly consumed 'foods included rice and finger millet, roots and tubers. Less than 50 % of families consume sorghum, irish potatoes, cassava, sweet potatoes, bananas mash in a week. Sorghum was rarely consumed by 86 % of the respondents, while 6 % consumed it once a week. The consumption of fruits and vegetables was varied. Kales were highly consumed by 47 % of respondents seven times a week. Less than 50 % of the families consumed pawpaw, mangoes, oranges, carrots, cowpeas, amaranth black and nightshade. Milk had high frequency of consumption with 79 % of the respondents taking milk seven times a week. Fish was poorly consumed by 7 % of families Of the 20 samples, each of maize kernels, muthokoi and maize meal, 45 % maize kernels were found to be contaminated with aflatoxins while 20 % and 35 % of muthokoi and maize meal, respectively, were also contaminated. The maize kernels, muthokoi and maize meal were found contaminated

Prevalence of overweight and obesity in association with diet and physical activity among national boarding high schools : a case comparison of Alliance high and Alliance girls high schools

Author: Mberia, Rose Kinya

Awarding University: University of Nairobi, Kenya

Level : MSc

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Alliance High School, Kenya ; Alliance Girls High School, Kenya ; Secondary school students ; Obesity ; Diet ;

Abstract:

Unconfmned reports suggest increasing levels of obesity and chronic diseases related to over-nutrition among High school students in Kenya. This poses the problem of the double burden of disease and malnutrition, which, if not addressed in time, will overwhelm the economy of the country such as Kenya. This study. design was crosssectional and comparative, designed to assess the prevalence of overweight and obesity in National High Schools, using a boys' and a girls' school as case study. The study assessed the prevalence of overweight and obesity in association with diet and physical activity. The study comprised 183 adolescent students aged 14-17 years: 90 girls from Alliance Girls High School (AGHS) and 93 boys Alliance High School (AHS) both located in Kiambu County. Overweight and obesity were determined using Body Mass Index (BMI for age) percentiles. Data was also collected on socio-demographics and the level of physical activity using a general questionnaire, and dietary practices using food frequency questionnaire. Data was analyzed using the Statistical Package for Social SCiences (SPSS). Categorical data was analyzed using chi square and Fishers Exact test while association between overweight and obesity and their predisposing factors were assessed using Pearson's correlation. Statistical significance was set at p<0.05. Results showed that the prevalence of overweight and obesity was 13.7% and 4.4% in the study population respectively. The prevalence of both overweight and obesity was slightly higher in girls (20 % and 5.6%) than in boys at (7.5% and 3.2%) respectively but there was no significant difference between two sexes. The study also established that there was no significant differences between BMI category and sexes using Fishers Exact test (P=1,OOO) (p >.05) among those who were overweight and obese. The percent of boys who engaged in sports was significantly higher than that of the girls. There was no significant relationship between hours spent on physical activity and BMI status, whether overweight or non -overweight. A significantly higher number of girls used their free time to do revision work and to catch up on pending assignments'. Significantly more of the overweight and obese students used their free time sitting and talking to their friends and surfing in the internet compared to non -overweight ones. Television watching and lor playing computer and! or video games occupied most of the students free time during weekends. The study shows that there was no significant difference in TV watching between sexes. A high proportion of both girls and boys spent more than 5 hours in front of the television during weekends (58.9% and 60.9% respectively. This study showed no significant difference between BMI status and time spent watching television and playing video games. Frequency of consumption of high calorie foods was positively correlated with the student's BM!. Overweight and obese adolescents consumed high calorie foods significantly more frequently than their non obese counterparts. The study concludes that the prevalence of overweight and obesity among adolescent High school students is high and factors contributing to this problem include frequent consumption of foods high in calorie, as well as low levels of physical activity. It is therefore recommended that students, teachers and diet planners in institutions be provided with information concerning health eating habits and physical activity.

Development of a supplementary food from selected local food ingredients to optimize nutritional and sensory qualities

Author: Kunyanga, Catherine N

Awarding University: University of Nairobi, Kenya

Level : PhD

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Dietary supplements/Nutrition/Food science ;

Abstract:

Recently there has been widespread consumption and sale of a diverse range of supplementary foods in Kenya. This situation bas been prompted by increase in malnutrition, AIDS and related diseases. and consumer nutrition and health awareness. This study was 1baefore designed to assess the diversity and characteristics of the supplementary foods utilized by the vulnerable groups with a view to document the existing foods in Kenya. The study also sought to explore ways of harnessing local food ingredients to develop a low-cost supplementary food appropriate for vulnerable groups. Local food ingredients such as finger millet, amaranth grain. pigeon peas. field beans, groundnuts, sweet potatoes, small dried fish (Rostrineobola argentea), amaranth and pumpkin were analyzed for macro- and micro-nutrients; amino acid and fatty acid profiles; bioactive compounds including phenolics, flavonoids, tannins and phytates, and their associated antioxidant and antidiabetic properties. The results of the analyses were used to identify appropriate food ingredients to be incorporated in four prefuninarY formulations from which the tinal supplement was selected as the most preffered by taste panel procedures. The most acceptable supplement was then analyzed for nutrient contents including macro- and micro-nutrients, amino acid and fatty acid profiles, shelf life and cost of production, the latter being done to estimate the selling price. Results show that the investigated food ingredients possessed high nutritional values. The food ingredients contained 6-44% protein; 8-38% fibre; 11-43% fat; 324-497 kcal energy; and 15-57'; carbohydrateS. The mineral contents of the food ingredients was in the range of 25-328 mgllOO g calcium, .0-51 mgllOO g iron, 44-1320 mgllOOg magnesium. 0.2-19 mgllOO g sodium. 60-1105 mgllOO g phosphorus, and .6-15 mgllOO g zinc. The indigenous vegetables exhibited 3.2-63 mgllOO g vitamin C and 0.7-5.1 mgllOO g jkaIOtene contt;nts while the grains showed 22-110 J.1g/100 g folic acid, 1.2-17.7 mg/l00 g niacin, 0.1-1.6 mg/l00 g vitamin Bl and 0.1-1.0 mg/l00 g vitamin B2 contents. The total essential amino acid content ranged from 2.7 to 10.4 % in the grains and 0.9 to 12.8% for the vegetables. The levels of the &tty acids in the food ingredients were 4.8-33.6% palmitic, 1.5-9.0% stearic, 2.2-53.9% oleic, 4.5-53.7% linoleic and 0.9-60.4% a-linolenic acids. Fish powder, sunflower seeds, pumpkin seeds, amaranth grain, pumpkin and amaranth leaves exhibited the highest content of essential amino acids. The total phenolic content of the cereals, legumes, and vegetables ranged from 0.41 to 3.00 g/IOO g DM with amaranth grains (Amaranthus cruentus) and drumstick leaves (Moringa oleifera) significantly exhibiting the highest contents. The phenolic extracts showed promising levels of antioxidant activity expressed as 2,2' -Diphenyl-l-picryl hydrazyl (DPPH) radical scavenging activity of 81-89%, and ferric reducing antioxidant power (FRAP) of 2.33-22.30 mg/mmol Fe[II]. The antidiabetic property was demonstrated by inhibition activities of a-amylase of 10-45% and a-glucosidase of 13-80%. The vegetables exhibited higher content offlavonoids (50-703 mg/l00 g) when compared to cereals, legumes and oil seeds (47-343 mg/100 g). The flavonoid extracts revealed 33-93 % of DPPH radical scavenging capacity, 0.12-2.77 llg/mM Fe[II] of Ferric reducing power, and 19-43% of aglucosidase inhibition activity as well as 14-68% of a-amylase inhibition activity. The tannin content of the cereals, legumes, and vegetables ranged from 1.53 to 4.35 gllOO g DM. The tannin extracts showed levels of DPPH radical scavenging activity of 77- 90%, FRAP of 47.2-3.6 mg/mmol Fe[II]), a-amylase inhibition activity of 24-40% and aglucosidase inhibition activity of 60-88%. The phytate contents of the grains ranged from 0.29 to 3.23 g/100 g DM. The phytate extracts showed levels of DPPH radical scavenging activity of 61-89%, FRAP of 37.3-3.6 mg/mmol Fe[II]),

Prevalence of overweight and obesity among high school students attending public schools in Nairobi

Author: Munguti, Cyrus Mutinda

Awarding University: University of Nairobi, Kenya

Level : MMED

Year: 2011

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Nairobi, Kenya ; Secondary school students ; Obesity ; Children and youth ; Teenagers ; Diet ;

Abstract:

Study title: Prevalence of overweight and obesity among high school students attending public schools in Nairobi Background: Obesity has become a global epidemic, affecting the developed as well as developing nations. Approximately 1.3 billion people in the world are obese. putting them at increased risk of morbidity and mortality, notably hypertension, Diabetes and early cardiovascular death. Childhood obesity has increased as well as adult obesity, and is largely blamed on changes associated with urbanization and socio-economic and environmental factors. Main Objectives: To determine the prevalence of overweight and obese status in high school children in Nairobi and to determine their dietary practice and physical activity profile. Study Design: Cross-sectional descriptive Survey. Study Site: The study was done in day public and faith-based schools in Nairobi province. Methodology: A total of 112 day schools were sampled and thirty schools selected for this study. Study Population and sample: Students in Public High Schools in Nairobi province in Fonn 1 to Form 4, approximated to age between 12 years to 20 years with calculated sample of 1,296 students. Data Collection tools: STEPS Questionnaire, Food frequency table, KAP questionnaire and observation data collection tools were used. Data Analysis: Data was analyzed using SPSS and presented in means, modes, median, frequencies, percentages and standard deviation. Results: Thirty (30) schools were selected to participate in this study, in which the 1300 students were interviewed and 1296 were enrolled in the study. There was a high response rate with 99.7% of the selected students participating in the study. The schools were geographically located in all the six districts of Nairobi. Three of these schools were located in Slum areas. The male to female ratio in the overall population was 1.4:1, with 59.1% being male and 40.9% being female. The majority of the study population (79.0010) was in the age group between 15-18 yrs. The prevalence of overweight in this population was 8.2% while prevalence of obesity was 2.2%. Abdominal obesity had a prevalence of 2.7%. Overweight and Obese status was more prevalent among the females, with a ratio {If 3.4:1. 79% of the population undertook the recommended adequate physical activity (more than 30mins per day for at least 3 days per week). Males were more active than females in the vigorous sports related exercise category (78.7% against 64.5% with a significant P <0.001). There was high intake of proteins and fats in this population, with 85.3% of the study population taking regular milk on a daily basis, 87.9% taking meat protein at least once daily. Other forms of proteins including eggs, vegetable proteins, were also consumed in high rates. Fat intake was also noted to be high, with 86.6% of the population taking some form offatS/oil daily. The intake of fried foods was 65.0% with the majority 57.3% of the students taking potato chips. In contrast, the intake of the recommended servings of fruits and vegetable was low in this study population, with only 22.90/. of the population taking the recommended servings (five or more servings) of fruits and vegetables. Statistically significant associations of Overweight and obese status was found to be age, gender, socioeconomic status, dietary practice and travel and sport related physical activity. Conclusion There is a high prevalence of overweight and obesity among students in day secondary schools in Nairobi. It is positively associated with gender, age, physical activity, dietary practice and socio-economic status.

Socio-cultural factors influencing nutritional status among women attending Pumwani Maternity Hospital, Nairobi

Author: Kigan, Wycliffe

Awarding University: University of Nairobi, Kenya

Level : MA

Year: 2010

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Maternal and child health services/Mothers/Nutrition/Diet/Socioeconomic factors/Women ;

Abstract:

The purpose of the study was to understand social cultural factors that influence maternal nutrition among women in perinatal period attending Pumwani Maternity Hospital. There are many factors that determine diet behavior among humans. In addition to personal preferences, there are cultural, social, religious, economic, environmental, and even political factors. Little is known about the magnitude of social factors which affect the nutritional intake in expectant and nursing mothers in Kenya. Nutritional intake has a direct effect on human health. Poor intake of food leads to nutrition deficiency diseases. The study was carried out at Pumwani Maternity Hospital. This hospital is the largest and busiest. Maternity hospital in east and central Africa. It serves a catchment of about half a million low income population. The study design was exploratory using triangulation of quantitative and qualitative approach. Thirty five mothers and five key informants were sampled. Interviews and observations as well as review of secondary data were the methods used to collect both the qualitative and quantitative data. Questionnaire, interview guide, and review of the mother's medical records were instruments of data collection. Data were analyzed using SPSS and presented in tables of frequency, pie chart and percentages. The main findings were that, unavailability of money and food preferences were the major factors that influenced food intake more than cultural and religion. Majority of the mothers had forms of nutritional disorders. Nearly 63% of the mothers said the main reason for not taking for not taking adequate or appropriate diet was inadequate money. About 23% cited large household size as an impediment to intake of adequate food. Nearly 91% percent mentioned food preference as the main reason of excluding certain foods from their diet. About 83% said religion does not influence what they eat. Nearly 60% of the mothers said cultural background influenced their food preference. About 54% of the mothers were assessed as having poor nutritional status by the nurse. Most social factors were not significantly associated with nutritional status of the mothers. The study concluded that the poor nutritional status of the respondent could be due attributed low purchasing power occasioned by poor education and lack of better paying jobs or income generating activities. Although mothers were knowledgeable about balanced diet, other factors impede them from practicing good dietary habits of adequate of quality food. A refocus on best ways to provide effective health and nutritional education is necessary. In the wake of a rise in female headed household, policies that insulate women from unfair competition for resources with men are necessary.

Dietary practices and nutritional status among people living with HIV/AIDS attending selected comprehensive care clinics in Thika district , Kenya

Author: Ndahi, Lucy Wanjiku Muhia

Awarding University: Jomo Kenyatta University of Agriculture and Technology, Kenya

Level : PhD

Year: 2010

Holding Libraries: Jomo Kenyatta University of Agriculture and Technology Library ;

Subject Terms: Thika District Hospital, Kenya ; HIV (infection) ; AIDS (disease) ; Diet ; Nutrition ; Health care ; Malnutrition ; Socioeconomic factors ; Jomo Kenyatta University of Agriculture and Technology, Kenya ;

Abstract:

The goal of nutritional care and support for PLWHA is to improve nutrition, health, quality of life and duration of survival. Good dietary practices play an important role in the comprehensive management of HIV/AIDS because it improves nutritional status, the immune system, boosts energy and helps in recovery from opportunistic infections. Though HIV/AIDS is a widespread problem in Kenya, there is little information about the dietary practices of PLWHA in the country. The extent to which those infected or affected can maintain good nutritional status of the infected varies widely. An observational longitudinal study with an aim of determining dietary practices and nutritional status was carried out among PLWHA in Thika District during a period of nine months. The study intervention was dietary counseling involving nutrition education and good dietary practices among PLWHA during the study period. The study centres were Thika District Hospital and JKUAT Hospital Comprehensive Care Clinics (CCC). Changes in nutritional status were assessed using BMI. The analysis of BMI as a continuous variable was used to evaluate change over time using the linear mixed effects model. The model was used to statistically assess effects of dietary practices and other factors on the nutritional status over time. Multivariate evaluation of participants' characteristics was managed using standard regression techniques. Statistical significance was set at 95% CI and for all statistical tests p s 0.05 was considered significant. Results showed that sex and education were significantly associated with nutritional status as measured by BMI. Females on average had 3.31 units of BMI higher than men (p<0.0001), while participants with secondary education and above had 2.22 and 3.15 units of BMI respectively higher compared to those with only primary education (p=0.035 and p=0.006), respectively based on multivariate Wald test. Those living in permanent quarters had BMI lower than those living in semi-permanent/temporary and this was statistically significant (p=0.014). The study also showed that income was not significantly associated with change in BMI over time, (p>0.05). Time as measured by visit month did not have a significant effect on mean BMI (P = 0.76). The predominantly consumed foods for lunch and supper were starchy carbohydrates. In conclusion, the study has shown that being female and having education higher than primary school level were significantly associated with enhanced nutritional status. This study also found that nutritional counseling during followup did not significantly influence changes in weight and therefore BMI over time. The participants with a mean BMI of ::018.5 kg/m2 were 8.1 % while those with BMI ~ 24.9 kg/m2 were 33.7% over time. Therefore, the total proportion of participants with malnutrition (both under and over nutrition) was 41.8%. The implication and recommendations of these findings is that malnutrition is a public health concern in Thika District and nutritional counseling and education alone may not lead to good dietary practices. It is also important to routinely evaluate the various interventions instituted at the comprehensive care clinics in order to determine their effectiveness and plan for appropriate changes when necessary.

Nutritional status, dietary practices and clinical factors of people living with HIV/AIDS attending Riruta Health Centre, Nairobi Kenya

Author: Nyansikera, Ruth Nyaboke

Awarding University: Jomo Kenyatta University of Agriculture and Technology, Kenya

Level : MSc

Year: 2010

Holding Libraries: Jomo Kenyatta University of Agriculture and Technology Library ;

Subject Terms: Nutrition ; Diet ; HIV (infection) ; AIDS (disease) ; Riruta Health Centre, Nairobi, Kenya ; Health education ;

Abstract:

Nutritional status is a significant predictor of survival rate in adult People Living with HIV/AIDS (PLWHA). While public opinion assumes that PLWHA are prone to malnutrition, there is very little documented data about their nutritional status, dietary practices and clinical factors specifically in urban poor settings in Kenya. This study considered the nutritional status, dietary practices and clinical factors of adult PL WHA in an urban poor setting. The main objective was to determine the nutritional status, dietary practices and clinical factors of adult PL WHA attending Riruta Health Centre (HIC), Nairobi, Kenya It was a cross sectional study conducted at Riruta Health Centre, Nairobi, Kenya. Systematic sampling of adult PL WHA attending the clinic was used to select study participants. A semi-structured questionnaire was pretested and used to collect data A written informed consent was sought and obtained prior to the interview. The study protocol was reviewed and approved by the Kenyatta National Hospital University of Nairobi (KNHlUON) Ethics Review Committee. Nutritional status was determined by Mid Upper Arm Circumference (MUAC) and Body Mass Index (BMI). The results showed that the mean age for the study participants was 36 ? 9 years. Seventy percent of them were females among whom 60% were married. Fifty seven percent of PL WHA attending Riruta Health Centre were unemployed. Majority (88.8%) of the study participants were from Nairobi West District. Their diets were most frequently staples that were predominantly carbohydrate rich foods. The diets were also limited in variety. The study participants consumed very little animal protein source foods and fruits. Overall, 25.8% of the study participants were undernourished. The proportion of males who were undernourished (42.3%) was about two times that of the females (18.7%). The clinical factors that were independently associated with being underweight were poor appetite (p = 0.0002, Crude Odds Ratio = 4.0885) and occurrence of opportunistic infections (p d 0.0027, Crude Odds Ratio = 2.9308). In conclusion, PL WHA attending Riruta Health Centre were mainly of low level education with high level of unemployment. They also had poor dietary practices. The prevalence of undernourishment among PLWHA was found to be 25.8 %. Nutrition interventions for PL WHA should focus on regular nutrition and health education, blending of locally available foods in the market to enrich their nutrient value and food fortification with selected micronutrients so as to improve the nutritional status of PL WHA.