Browsing by Author "Chege, Peter"
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Item An Assessment of Food Safety Practices among Street Vendors in Mombasa, Kenya(IJHSR, 2018) Odundo, Alice; Okemo, Paul; Chege, PeterStreet vended foods have gained popularity due to economic benefits. However, they have been recognized as a potential hazard to public health. Minimal information exists on the safety and hygiene of street foods. This study aimed to assess the hygienic practices of the street food vendors in respect to their training in basic food hygiene. The study adopted a descriptive survey in Mombasa Island on a sample of 100 randomly selected vendors. The focus was on vendors selling mahamri, mbaazi and samosa. Chi-square (χ2) was used to test the relationship between training and various aspects of hygiene. T- Test and analysis of variance was used to assess for any significant differences between study variables. Results notes poor hygiene practices like wearing of jewellery (37%), having long and unclean nails (43%) and lack of protective clothing (36%). Men had better hygienic practices than women (P<0.05). Hygiene practices significantly (P<0.05) related to the training where those trained were found to observe hygiene. The study concluded that the street-vended foods are not safe as they are exposed to food safety risks. It is recommended that street food vendors be trained, recognized and licensed to enable them produce safe food.Item Constraints and opportunities for implementing nutritionspecific, agricultural and market-based approaches to improve nutrient intake adequacy among infants and young children in two regions of rural Kenya(2016) Hotz, Christine; Gretel, Pelto; Margaret, Armar-Klemesu; Ferguson, Elaine F.; Chege, Peter; Musinguzi, EnockSeveral types of interventions can be used to improve nutrient intake adequacy in infant and young child (IYC) diets, including fortified foods, home fortification, nutrition education and behaviour change communication (BCC) in addition to agricultural and market-based strategies. However, the appropriate selection of interventions depends on the social, cultural, physical and economic context of the population. Derived from two rural Kenyan populations, this analysis combined information from: (1) a quantitative analysis to derive a set of food-based recommendations (FBRs) to fill nutrient intake gaps in IYC diets and identify ‘problem nutrients’ for which intake gaps require solutions beyond currently available foods and dietary patterns, and (2) an ethnographic qualitative analysis to identify contextual factors posing opportunities or constraints to implementing the FBRs, including perceptions of cost, convenience, accessibility and appropriateness of the recommended foods for IYC diets and other social or physical factors that determine accessibility of those foods. Opportunities identified included BCC to increase the acceptability and utilisation of green leafy vegetables (GLV) and small fish and agronomic interventions to increase the productivity of GLVand millet. Value chains for millet, beans, GLV, milk and small fish should be studied for opportunities to increase their accessibility in local markets. Processor-level interventions, such as partially cooked fortified dry porridge mixes or unfortified cereal mixes incorporating millet and beans, may increase the accessibility of foods that provide increased amounts of the problem nutrients. Multisectoral actors and community stakeholders should be engaged to assess the feasibility of implementing these locally appropriate strategiesItem Determinants of Complementary Feeding and Nutrition Status of Children 6-23 Months in Vihiga County, Kenya(Bioaccent Group, 2017) Kimiywe, Judith; Chege, PeterThe age 6-23 months is a vulnerable stage of growth mainly due to poor complementary feeding practices. This study aimed to assess the adequacy of complementary foods and explore opportunities of using locally available foods to improve nutrient intake. The research was carried out in four randomly selected districts in Vihiga County, Western Kenya.A cross sectional analytical design was used on a sample of 201 children aged 6-23 months. Actual measurement of the amount of foods consumed was done. Data were analysed using the ENA for SMART, Nutri-survey and SPSS computer software. Most caregivers (78.2%) had low education level of below primary school, were farmers or casual labourer (48.8%) and 77.1% had low levels of income (< 8000 KES). The average household size was 5.71. About 74.6% of infants were breastfed. The average number of meals consumed per day was 4.2. The diet contained more of the starchy foods than the other food groups. Except for protein consumed in adequate amounts by 52%, over 50% did not meet the RDAs for other nutrients including energy. The children consumed a variety of traditional vegetables which were however served as broth. Fruits were not frequently consumed by over 40% of the children. The levels of wasting, stunting and underweight were 3.5%, 15.4% and 7.5%, respectively. The complementary feeding practices did not enable the children to meet the macronutrient and micronutrients requirements. This study recommends use of locally available foods to improve nutrient intake.Item Dietary diversity, dietary iron intake and iron status among pregnant women in Embu county, Kenya(2014-07-30) Mwaniki, Nicoleta Muthoni; Chege, PeterIron deficiency is one of the most common micronutrient deficiencies in the world today. Maternal anemia is still a cause of considerable prenatal morbidity and mortality. The number of anemic women in the world is estimated to be 56 million, majority of them (75-80%) being diagnosed with iron deficiency anemia. In Kenya iron deficiency for women of reproductive age is at 48% while anemia in pregnancy is at 55%. One of the most important factors responsible for maternal iron deficiency is poor dietary practices. Dietary diversification is essential for nutrient adequacy as there is no single food that contains all the nutrients required to maintain good health and nutritional status. The purpose of this study was to establish dietary diversity, iron intake and iron status among pregnant women in Embu County. Cross- sectional analytical design was used and the sample size was 172 pregnant women. Sampling was done by systematic sampling technique. A structured researcher administered questionnaire was used to collect data on dietary diversity and iron intake and demographic and socio- economic characteristics of pregnant women.Mid upper arm circumference (MUAC) was used to assess nutritional status; iron status was assessed by measuring serum hemoglobin (HB) levels. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) Version 16 software. Data from 24 hour recall was analyzed using Nutri-survey. Pearson correlation and chi–square were used to determine the relationship and association between variables. The statistical significance was set at a value of p< 0.05. Data was presented as frequencies, percentages and means. The mean age of the study population was 27±5.3 years, 88.4% were married, and 68.3% had attained secondary education. About 28% of the participants were not meeting the minimum dietary diversity for women (MDD-W).About 45.7% were not meeting the recommended dietary allowances (RDA) for dietary iron and 20.1% were anemic. The MUAC mean was 26.9 ±3.7 with 86.6% having MUAC of 23 or more. A significant relationship was found between the level of income and dietary diversity score (DDS)(r=0.39, p=0.047),DDS and HB (r=0.48, p=0.041),iron intake and DDS (r=0.57,p=0.038 ) and between iron intake and HB (r=0.54,p=0.031).A significant relationship was found between MUAC and DDS (r=0.26, p=0.03).A significant association was found HB and morbidity (χ2) = 7.98, p= 0.034).It is recommended that dietary diversity and intake of adequate dietary iron be promoted through regular talks and demonstrations to the pregnant women attending the mother and child health (MCH) clinic at all health facilities. The information obtained from this study may be useful to the ministry of health in the county in designing appropriate interventions programs to promote adequate dietary iron intake and mitigate iron deficiency anemia among pregnant women in Embu County.Item Dietary Diversity, nutrient intake and nutritional status among pregnant women in Laikipia County, Kenya(2016) Kiboi, Willy; Kimiywe, Judith; Chege, PeterBackground/Aim: Pregnancy is a critical period during which adequate nutrition is considered an important factor that affects birth outcome and the health of the mother. Maternal diets during pregnancy have thus been deemed critical since the diet must meet the nutrient requirement for both the child and the mother for satisfactory birth outcome. Research has clearly shown that a diverse diet is strongly associated with nutrient adequacy and better maternal nutritional status. The purpose of this study was to assess dietary diversity, nutrient intake and nutritional status among pregnant women in Laikipia County, Kenya. Methods: This was a cross-sectional analytical study. The study comprised of 254 pregnant women attending antenatal clinic at Nanyuki Teaching and Referral Hospital. Results: The study revealed that the mean Dietary Diversity Score (DDS) was 6.84 ± 1.46 SD The mean intake of energy, carbohydrate, protein, fat, zinc, iron, folate and vitamin C was inadequate while those of Vitamin A and calcium were adequate. In respect to nutritional status, 19.3% were undernourished based on Mid-Upper Arm Circumference (MUAC) while 16.9% were anemic based on haemoglobin levels. The result further showed that dietary diversity was positively correlated with nutrient intake and nutritional status. Conclusion: Dietary diversity is crucial in ensuring adequate nutrient intake and nutritional status among pregnant womenItem Dietary practices and nutrition status of adult pulmonary tuberculosis patients attending Nyeri County Referral Hospital, Kenya(Scholars Middle East Publishers, 2017-11) Mwendia, Agnes Wangari; Chege, Peter; Njogu, EuniceThe purpose of this study was to assess the dietary practices and nutrition status of adult pulmonary TB patients attending Nyeri County Referral Hospital, Kenya. The study adopted a cross-sectional analytical design. A sample of 135 participants was calculated using the modified Fisher Formula. The study targeted adult pulmonary TB patients attending TB Clinic. A structured questionnaire and a focus group discussion guide were used to collect data. Data was analyzed using Statistical Package for Social Sciences. About 48.1% of the participants were underweight while 45.9% were normal and 3.7% were overweight. Chi-square tests showed significant relationships between gender (χ2 = 10.917, p=0.012), age (χ2 = 12.261, p=0.046) and income (χ2 15.584, = p=0.036) were significant to nutrition status among the socio-demographic characteristics. Pearson correlation analysis showed a weak relationship (r=0.173, p=0.045) between number of meals per day and nutrition status of TB patients. The study concluded that adult pulmonary TB patients attending Nyeri county referral hospital had poor dietary practices, which led to poor nutrition status. The study recommended that food assistance programs should be strengthened by the government in conjunction with non-governmental organizations to help in mitigating increased vulnerability to food insecurity among TB-affected households. Keywords: Dietary Practices, Extra Pulmonary T.B, Nutrition Status, TB Patient and Pulmonary T.BItem Dietary Practices of Cancer Outpatients at Nyeri County Referral Hospital, Kenya; A Cross Sectional Survey(International Journal of Nutrition and Food Sciences, 2024-11) Bundi, Dorothy; Chege, Peter; Kamuhu, ReginaThe global burden of non-communicable diseases remains unacceptably high and Kenya is among the countries experiencing an epidemiological transition from the communicable to non-communicable diseases. In Kenya, cancer is the second leading cause of non-communicable disease related mortalities after the cardiovascular diseases and Nyeri County is among the counties that are leading in this burden of non-communicable diseases. This study sought to assess the dietary practices of the cancer patients on chemotherapy at Nyeri County and Referral Hospital in comparison with the recommended dietary practices. Analytical cross-sectional study design was employed and the data on the dietary practices was collected using a 24-hour recall and a Food Frequency Questionnaire (FFQ). Sixty one percent of the respondents were female while 39% were male. Sixty one percent had acquired primary school education and half of the respondents survive on a monthly income of between 0-10,000. Breast cancer was the most common cancer type in the population (39%), followed by esophageal and throat cancer at 14.5% and gastric cancer at 14%. Prostate cancer was the most prevalent among the male respondents at 11%. The mean energy intake of the respondents was 1068+- 520 Kcals which was not meeting the requirements as per the ESPEN clinical guidelines on cancer. The dietary patterns identified from the research were, excessive consumption of foods from the starchy foods and the fats category (65.1%) and less than half (41.9%) were not attaining the minimum daily requirements of the fruit’s servings recommended by the World Health Organization (WHO). Nutrition education and counselling is key in improving the dietary practices among the cancer patients. However, 44.19% had not received nutrition education and counselling regarding the appropriate diet to consume in the course of their treatment. This study found out that the dietary practices of the cancer patients do not meet the recommended clinical guidelines on cancer nutrition and almost half of the population had not received nutrition education and counselling services. Social and behavior change is one of the possible strategies that could be adopted to deliver nutrition information to the population, to improve the knowledge, attitude and dietary practices of cancer patients in Kenya, which in turn will improve their nutrition outcomes.Item Efficacy Of Dried Amaranth Leaves (Amaranthus Cruentus) Consumption On Vitamin A, Iron and Zinc Of Children In Kajiando County, Kenya(2013-07-19) Chege, PeterVitamin A, iron and zinc are currently among the major micronutrients of public health concern in the world. Children under five years are more vulnerable to the deficiencies. Globally, vitamin A deficiency affects about 250 million children under five years. It is estimated that 51% and 31% of the children in the world have iron and zinc deficiencies, respectively. In Kenya, the prevalence of vitamin A, iron and zinc deficiencies among children is 84%, 74% and 50%, respectively. Thus, there is a need for sustainable methods to address the deficiency. The intake of animal products among the Maasai community has declined. Solar dried amaranth leaves can be used to improve the dietary intake. Minimal information exists on how intake of dried vegetables incorporated into cereal flours would translate to improved micronutrient status. With this background, the possible effect of consuming dried amaranth leaves (DAL) incorporated in fermented maize flour (FMF) on the status of vitamin A, iron and zinc among children under five was investigated in Sajiloni, Kajiado County. A pre-test–post-test control group design was adopted. A comprehensive sample of 46 children aged 24 - 48 months for experimental group and 46 for control group was used in this study. A maize-amaranth blend (85:15%) which provided at least 100% of the RDAs for vitamin A was formulated using Pearson square for the experimental group while pure fermented maize flour porridge was used for the control group. The children consumed 250 mls of the porridge twice a day for six months. Dietary practices, morbidity pattern and nutrition status of the children was monitored on monthly basis while the serum levels for vitamin A, zinc and iron were done at baseline and at six months. The β - carotene in DAL, FMF and the formulated porridge were analysed using UV-VIS Spectrophotoscopy, while iron and zinc using Absorption Spectrophotometry (AAS). Serum level analysis was done by use of AAS (MINI VIDAS) for iron and (Shimadzu AA-680) for zinc content. High performance liquid chromatography (HPLC) was used to analyze β – carotene, retinol and ferittin and zinc. ENA for SMART software was used for analysis of anthropometric data while Nutri-survey was used for analysis of nutrient intake. Data were further analyzed using SPSS computer software. The relationship between amaranth intake, dietary practices, morbidity patterns and serum levels of retinol, β - carotene, ferittin and zinc was assessed using Pearson correlation, regression and chi-square. From the results, the formulated porridge DAL/FMF (15:85) was acceptable. Solar drying of amaranth led to a high concentration of nutrients and a higher retention of β – carotene, iron and zinc. The nutrient content of the DAL/FMF porridge was 6.81 ± 0.77, 12.05 ± 0.63 and 5.55 ± 0.41 mg/100g for β – carotene, iron and zinc, respectively. Intake of porridge made of 60 g of amaranth based flour enabled the children to attain the RDAs. Dried amaranth leaves were stable and safe for consumption after 9 months storage. The education level was low and household income was low. The nutrition knowledge level among caregivers was low. Inadequate intake of micronutrients led to high prevalence of illnesses. Majority of the children from both groups had low mean serum levels for retinol, β - carotene, ferittin and zinc at baseline showing deficiency. This significantly increased among the experimental group by the sixth month suggesting the role of DAL towards improving the status of these nutrients. Thus, DAL incorporated into cereals to significantly increased micronutrients intake. This study recommends the use of DAL as part of the diet for children.Item Level of micronutrient supplements uptake among people living with HIV/AIDS in Kayole, Nairobi County, Kenya(Academic Journals, 2017-04) Chege, Peter; Muthamia, Olive GaceriMicronutrients reduce morbidity and slow the rate of disease progression and thus, micronutrient supplementation in HIV is recommended. This study established the level of uptake of micronutrient supplements among people living with HIV in Kayole, Nairobi County. A cross-sectional analytical design was adopted on a comprehensive sample of 153 adults living with HIV, enrolled at Comprehensive Care Centre in Kayole Health Centre. Data is described by use of percentages while relationships are assessed using chi-square. Qualitative data from focus group discussions and key informants was transcribed and analyzed to complement the quantitative findings. Results showed that only 13.7% of the respondents were on micronutrients at the time of the study. The micronutrient supplements commonly supplemented were vitamin and mineral mix (50.3%), zinc (34%), vitamin B6 (24.2%), vitamin A (24.2%), folate (12.4%), and iron (15%). The main reason for supplementation was; those on Antiretroviral Therapy (66.7%), due to the presence of opportunistic infections (40.5%), those who had no appetite (28.1%), underweight cases (21.6%) and those on tuberculosis treatment (17.0%). The main reason for low uptake was due to stock outs at treatment centre (24.8%), the high cost of supplements (13.7%) and side effects after intake (5.9%). Adults living with HIV are aware of the importance of micronutrients and had taken micronutrient supplements at one point during the treatment period. However, uptake at the time of the study was low. This was due to lack of guidelines for supplementation, high cost of supplements, stock-outs in health facilities and side effects. This study recommends proper education and sensitization on supplementation. Standard guidelines and policies for micronutrient supplementation should be developed. A pull system should be adapted in the supply of supplementsItem Longitudinal Changes of Human Milk Nutrient Content in the First 6 Months of Lactation(Science and Education Publishing, 2020) Kiboi, Willy; Kimiywe, Judith, C; Chege, PeterHuman milk is considered to be the optimal source of nutrition during the first six months of a child’s life. Since the milk is the only source of nutrition for the first six months of an infant’s life, understanding its composition remains a matter of public health concern. Further, few studies have determined the breast milk composition of lactating mothers in African countries. The aim of this research was to assess longitudinal changes of human milk nutrient content in the first 6 months of lactation. A longitudinal descriptive study with repeated measures was adopted by the study. Breast milk nutrient composition was assessed among lactating mothers at the 1st and the 5th month of lactation. The milk energy, lactose, protein, lipids, vitamin A, calcium, magnesium, zinc and iron was assessed at the two time points of lactation (first and fifth month). A total of 104 mature breast human milk samples were collected and analysed for energy and the selected nutrients at the two stages of lactation. Significant differences in the mean nutrient content of proteins (p value = 0.029), vitamin A (p value = 0.004) and iron (p value = 0.015) was observed between the first and the fifth month of lactation. A downward trend in the mean nutrient content for protein was observed while an upward trend was observed for both vitamin A (retinol) and iron between the 1st and 5th month of lactation. Human milk nutrient content varies longitudinally in the first six months of lactation. Studies investigating the causes of the variations are critical in improving the quality of human breast milk and ultimately the growth and development of a child.Item Malnutrition Diagnosis among Cancer Outpatients Using Malnutrition Universal Screening Tool in Nyeri County Referral Hospital, Kenya(International Journal of Nutrition and Food Sciences, 2024-09) Bundi, Dorothy; Chege, Peter; Kamuhu, ReginaCancer burden remain unacceptably high with global incidence of 19.3 Million and 10million cancer mortalities according to the 2020 global cancer estimates. There has been notable improvement in cancer care in Kenya but malnutrition in cancer patients remain highly under-recognised and the malnutrition screening tools remain under-utilised especially in Nyeri county. The main objective of this study was to determine the malnutrition risk among the cancer outpatients attending Nyeri County Referral Hospital using Malnutrition Universal Screening Tool using analytical cross-sectional study design. Sixty one percent of the respondents were female while 39% were male. Breast cancer was the most common cancer type in the population (39%), followed by esophageal and throat cancer at 14.5% and gastric cancer at 14%. Prostate cancer was the most prevalent among the male respondents at 11%. Using the MUST, more than half (51.7%) of the respondents were at a high risk of developing malnutrition, followed by low risk (32.6%) with only 15.7% respondents being at a medium risk of malnutrition. Using the BMI, half of the respondents, (50%) had a normal nutrition status and only 19.8% respondents were underweight. There is a significant difference between classifying nutrition status of cancer patients using BMI and Malnutrition Universal Screening Tool (PItem Nutritional Status and School Performance among Upper Primary Children in Selected Public Schools in Nairobi County, Kenya(International Journal of Health Sciences and Research - See more at: http://www.ijhsr.org/#sthash.0mhugdCC.dpuf, 2016) Githinji, Phrashiah; Chege, Peter; Githinji, ScolasticaBackground/Aim: School-age is a critical period during which adequate nutrition is considered an important factor that affects learning capabilities. There is an emergence of the dual burden of malnutrition among children in urban setups like Nairobi and yet there is limited information on the effect of these on school performance. Research has shown that nutritional status affects children’s development. The purpose of this study was to investigate the relationship between nutritional status on school performance among children in upper primary in selected public schools in Nairobi County, Kenya. Methods: This was a cross-sectional analytical study. The study comprised of randomly selected 256 children from public schools within Nairobi County. Results: The study confirmed that there is concurrent dual burden of malnutrition among adolescent school children in Nairobi County; (8.6% were overweight while 9% were undernourished). Children with higher Z-scores/ BMI were found to be more likely to be inactive during field games and they preferred sitting in the field during physical activities (P ≤ 0.05). Children within normal weight for their age showed higher chances of performing well in classroom activities such as completion of assignments (P ≤ 0.05). However, the study showed no correlation between nutritional status and attendance. Conclusion: Children’s nutritional status influences their school performance in extra-curriculum activities namely; filed games and school clubs as well as completion of homework assignments.