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Item Empowering youth as agents of change: Gaps and opportunities for meaningful youth engagement (MAYE) for sustainable nutrition, climate and public health programmes(John Wiley & Sons Ltd, 2024) Gaithuma,Joseph; Chor,Samuel; Natukunda,Angela; Shahleen,Pturgo; Kavle,Justine A.Addressing the intersection of food insecurity, malnutrition and climate change in Sub‐Saharan Africa requires meaningful adolescent and youth engagement to drive sustainable change. Drawing on empirical evidence and collective experiences from youth‐led initiatives and coalitions, four gaps and opportunities to better involve youth in programmes are discussed, including, the need to: (1) standardise the definition of youth to improve programme design and data harmonisation, (2) provide capacity building and mentorship for youth leadership in health service delivery, (3) foster youth leadership and multisectoral collaboration in food and health systems and (4) enhance capacity development for non‐youth actors to support genuine youth participation. This viewpoint underscores the importance of involving African youth in public health nutrition, climate change and food security programmes design and implementation—as drivers of change to addressing hunger and climate crises. By centering youth voices and experiences, programmes and policies can better address African communities' complex challenges, fostering inclusivity, sustainability and resilience in achieving better nutrition and public health programmes and outcomes.Item Physiochemical, Proximate Composition and Microbial Quality of a Novel Probiotic Yoghurt Fortified with Purple-Leaf Tea (Camelias Sinensis)(AJFAND, 2024-12) Mucheru, P.; Chege, P.; Muchiri, M.With the increasing demand of health promoting food products, formulations of yoghurts are changing more towards live probiotic starter culture milk fermentation and fortification with plant-based food ingredients to improve the flavour and nutrition composition. Synbiotic yoghurts fermented with probiotic microbes and fortified with prebiotic food ingredients have become very popular as functional foods due to their scientifically proven bioactive compounds that promote human gut health and alleviate dysbiosis. The aim of the current study therefore, was to assess the physiochemical, nutritional proximate composition and viability of probiotics in formulated yoghurt fortified with a novel purple-leaf tea (Camelias sinensis) puree that is rich in anthocyanins, bioactive polyphenols. Whole milk was fermented with probiotic starter culture (Lactobacillus acidophilus (LA-5), Bifidobacterium animalis subsp. lactis -ABT 5) from CH Hansens Limited. Subsequently, the yoghurt was fortified with a novel purple tea puree at the Food and Tea Science Workshop of Karatina University, Kenya. Proximate composition and physiochemical properties (pH and mineral salts profile) were analyzed both in the formulated probiotic yoghurt (PYFPT) and control yoghurt without the tea puree. The viability of the probiotic colony forming microbes was determined using the De Man, Rogosa and Sharpe (MRS) anaerobic bacteria selective culturing agar media. The pH results of PYFPT (4.24 ± 0.04) was not significantly different (p< 0.05) to that of the control yoghurt even after 28 days of refrigerated storage. However, proximate composition recorded significant differences except for the crude fiber content (0.01 ± 0.01 %). A higher percent moisture content and crude lipid was recorded in the control yoghurt (88.18±0.01 and (2.11 ± 0.02) than the PYFPT (78.14±0.04 and 1.33 ± 0.09). Inversely, higher percentage of crude protein, carbohydrates and crude mineral salts were recorded in the formulated PYFPT (7.96±0.27, 11.17±0.25; 0.81±) than control yoghurt (4.23±0.01, 5.44±0.04, 0.59±0.01). A profile of ash content of the added purple tea puree recorded 16 different mineral salts. The macro minerals were the major, with potassium recording the highest content (282 ppm), followed by sodium (121 ppm), magnesium (97.2 ppm) and calcium (96.4 ppm). The microbial anaerobic probiotic count (6.14 - 6.80 log CFU/ml) was not statistically and significantly different between the PYFPT and the control yoghurt after 28 days of refrigerated storage. In conclusion, the study demonstrated that it is feasible to formulate nutritious probiotic yoghurt fortified using purple-leaf tea puree with potential for commercialization.Item Feasibility of Delivering Vitamin a Supplementation (VAS) and Deworming Through Routine Community Health Services in Siaya County, Kenya: A Cross‐Sectional Study(John Wiley & Sons Ltd, 2024-01) Ochola, Sophie; Lelei, Asa; Korir, Julius; Ombati, Caleb; Chebet, Caroline; Doledec, David; Mutea, Fridah; Nielsen, Jennifer; Omariba, Solomon; Njeri, Esther; Baker, Melissa M.Vitamin A deficiency and soil‐transmitted helminth infection are serious public health problems in Kenya. The coverage of vitamin A supplementation and deworming medication (VASD) provided through mass campaigns is generally high, yet with a cost that is not sustainable, while coverage offered through routine health services is low. Alternative strategies are needed that achieve the recommended coverage of >80% of children twice annually and can be managed by health systems with limited resources. We undertook a study from September to December 2021 to compare the feasibility and coverage of VASD locally delivered by community health volunteers (CHV) (“intervention arm”) to that achieved by the bi‐annual Malezi Bora campaign event (“control arm”). This comparative cross‐sectional study was conducted in sub‐counties of Siaya County using both qualitative and quantitative methods. VASD were offered through the CHS in Alego Usonga and through Malezi Bora in Bondo Sub‐County. Coverage was assessed by a post‐event coverage survey among caregivers of children aged 6–59 months (n = 307 intervention; n = 318 control). Key informant interviews were conducted with n = 43 personnel across both modalities, and 10 focus group discussions were conducted with caregivers of children aged 6–59 months to explore knowledge, attitudes and perceptions of the two strategies. VAS coverage by CHV was 90.6% [95% CI: 87.3–93.9] compared to 70.4% [95% CI: 65.4–75.4] through the Malezi Bora, while deworming coverage was 73.9% [95% CI: 69.0–78.7] and 54.7% [95% CI: 49.2–60.2], respectively. With sufficient training and oversight, CHV can achieve superior coverage to campaignsItem Assessment of Nutritional Status among Undergraduate Students at a Nairobi Tertiary Institution Using BMI and Waist Circumference Metrics(AJND, 2024-06) Ndung’u, Joseph Mburu; Waudo, Judith; Kobia, JosephThis study investigated the impact of dietary and lifestyle changes on the nutritional status of undergraduate students during their transition to university life and the associated risk for non-communicable diseases. A review of global studies indicated varying prevalence rates of overweight and obesity among university students, influenced by diet, physical activity, and sleep patterns. This research specifically assessed the nutritional status of Kenyatta University students in Nairobi, Kenya, with an emphasis on the limited studies utilizing both BMI and waist circumference for assessment. Employing a cross-sectional, analytical design, the study was conducted at Kenyatta University Main Campus in Nairobi County. This public research university, founded in 1970, was selected for its urban setting and its representation of young adults. The target population comprised undergraduate students pursuing bachelor’s degrees, with inclusion criteria of voluntary participation and at least six months on campus. Multi-stage stratified sampling was used to select 260 participants. Data were collected through a structured questionnaire, pretested on 10% of the sample, with reliability assessed via a test-retest method. Anthropometric measurements were taken by trained research assistants. Data analysis was performed using SPSS version 24, evaluating nutritional status with BMI and waist circumference. Ethical considerations and COVID-19 protocols were rigorously observed. Findings revealed that, based on BMI, 67.5% of respondents had normal weight, while 8.4%, 16.5%, and 7.6% were underweight, overweight, and obese, respectively. The overall prevalence of overweight and obesity (BMI ≥ 25) was 24.1%. Female respondents showed a higher prevalence of obesity (63.2%) and overweight (73.2%) compared to males. In the underweight category, more males were underweight (57.1%) than females. Waist circumference assessment indicated that 21.7% had abdominal obesity, with a higher prevalence among females (87%) compared to males (13%), highlighting a gender-based risk factor for abdominal obesity. The study’s BMI analysis revealed a substantial proportion of respondents within the normal weight range, with significant gender disparities in obesity and overweight prevalence. The waist circumference assessment underscored a notable occurrence of abdominal obesity, particularly among females, indicating gender-specific susceptibility to this health concern.Item Effect of Blanching Time–Temperature on Potassium and Vitamin Retention/Loss in Kale and Spinach(WILEY, 2024-03) Mugo, Beatrice Muthoni; Kiio, JulianaHyperkalemia is common among patients with end stage kidney disease. Management involves diet modification. Hot water blanching is recommended to leach potassium in vegetables which results in losses of water-soluble and heat labile vitamins. Evidence on the effect of blanching in reducing potassium level of locally consumed vegetables in Kenya is limited. This study sought to establish effect of hot water blanching timetemperature on level of potassium, vitamin B1, B3 and C in kales (Brassica oleracea var. acephala) and spinach (Spinach oleracea) on potassium and vitamins B1, B3 and C retention/loss. The study adopted a full factorial experimental design. Vitamins were determined using high performance liquid chromatography. Potassium was quantified using atomic absorption spectrophotometry. To compare nutrient content between samples, independent t-test and Analysis of Variance were used at 95% confidence level. Nutrient content of fresh kales and spinach were potassium (102 mg/100 g and 615 mg/100 g), vitamin B1 (124 μg/100 g and 51 μg/100 g), vitamin B3 (1165 μg/100 g and 812 μg/100 g) and vitamin C (102 mg/100 g and 116 mg/100 g) respectively. In kales, blanching for 20 min at 1000°C resulted to retention of 86.9%, 55.6%, 27.6% and 12.9% of vitamin B1, B3, C and potassium respectively. In spinach, blanching for 20 min at 1000°C resulted in retention of 79.9%, 88.6%, 12.2% and 40.6% retention of vitamin B1, B3, C and potassium respectively. Vitamin C and Potassium were the most sensitive to heat and leaching. Time had a greater effect than temperature in this study. This study recommends blanching of kale at 15.2 min at 800°C, spinach at 17.7 min at 840°C. Further research on optimal blanching time-temperature for potassium and vitamin retention/loss is recommended.Item Diet and Comorbidities Affecting Hemodialysis Patients at the Renal Unit in Kenyatta National Hospital, Kenya: A Cross Sectional Analytic Study(IJHSR, 2023-07) Maina, Muthoni Rachael; Waudo, Judith Ndombi; Kamuhu, Regina WanguiThough there are good guidelines by the Kidney Disease Outcome Quality Initiative on the recommended dietary energy and protein intake, haemodialysis patients are unable to meet because of dietary restrictions to prevent sodium, potassium and phosphorus mineral imbalances, low socioeconomic status and presence of comorbidities. In Kenya 4% are affected by renal failure which may not be the true burden as the country lacks national renal registries. There is inadequate information on the actual dietary intake and comorbidities affecting the haemodialysis patients in Kenya which this study sought to answer. A cross-sectional analytic study was conducted among 84 respondents undergoing haemodialysis present during the month of November 2021 at Kenyatta National Hospital renal unit. They were selected using consecutive purposive sampling. Data collection was done using a researcher administered digitalized questionnaire for the sociodemographic and economic factors, selected comorbidities that affect dietary intake, two 24hr dietary recalls both on non-dialysis and dialysis days, a 7-day food frequency questionnaire and nutrition supplement consumption. Statistical Package for Social Sciences (SPSS) Version 25 was used to analyse data. The mean age was 42.24±16.6 years with 41 males and 43 females. Employed were 38.1% and 66.7% relied on family for financial support. Fluid overload (50%), Diabetes Mellitus (20.2%), severe gastrointestinal disturbances (10.8%), present or past malignancy (4.8%) and cardiovascular illness (4.8%) were the comorbidities present among the respondents. The average energy intake was 14.738±8.46 kcals/ kg body weight/ day with non-dialysis energy intake being statically significantly higher (p=.017) than on dialysis day. The mean protein intake was 0.43g/kg/day. The mean daily micronutrient intake was as follows: sodium, 904.54±805.27mg; potassium 973.57±595.2mg; phosphorus, 549.835±401.91mg; calcium, 203.78±127.325mg; zinc 4.92±4.02mg; vitamin C, 42.83±31.58mg; and vitamin B6, 0.815±0.685mg. This study reveals that there is low dietary macro and micronutrient intake among haemodialysis patients particularly intradialytic days.Item The Potential Health Benefits of a Novel Synbiotic Yogurt Fortified With Purple-Leaf Tea in Modulation of Gut Microbiota(BCHD, 2024-04) Patrick, Mucheru; Peter, Chege; Mary, MuchiriBackground: The use of synbiotic functional yogurt is a trending dietary approach of positively modulating the gut and alleviating dysbiosis. These yogurts are fermented using probiotic live microorganisms that confer health benefits on the host. Purple-leaf tea (Camellia sinensis) which contains prebiotic polyphenolic compounds, has all the health benefits of tea in addition to high content of flavonoid bioactive anthocyanin compounds. Object ve: The goal of the current study was to investigate the effect of a novel symbioti yogurt fermented using probiotic microbes and fortified with purple leaf tea puree in modulating gut bacteria profile using an in vivo animal experiment with white male Wilstar rats. Methods: An in vivo animal study was used to investigate the effect of synbiotic yogurt (PYPT) produced by fermentation of milk with probiotic starter culture ABT 5 (Lactobacillus acidophilus LA-5, Bifidobacterium bifidum BB-12 and Streptococcus thermophiles) and fortified with purple-leaf tea puree. A total of 16 Wistar rats were intraperitoneally injected with 8 doses of 4mg/g of monosodium glutamate (MSG) to induce obesity. In a randomized control design, 8 of the experimental control rats were fed with normal standard rat feed, while 8 intervention rats were fed with the formulated yogurt for a period of 28 days. The gut health bacteria biomarkers were determined from the rats’ fecal matter by extraction of DNA using the ZymoBIOMIC kit protocol and profiled by the polymerase chain reaction (qPCR) molecular technique, of 16S rRNA. The data of the bacteria taxonomic classifications and abundance was processed and interpreted using DADA2 package and Quantitative Insight into Microbial Ecology 2 (Qiime2). Results: No statistical differences in diversity of bacterial phyla were reported, but the composition of Actinobacteria increased in the intervention group and decreased in the control, while Proteobacteria decreased drastically in the intervention rats. Notably, the population of beneficial Lactobacillales and Bifidobacteriales in the intervention cohort increased significantly, while there was a reduction of bacteria with species with potential of pathogenic activity. Conclusions: Fortification of probiotic yogurt with purple tea with prebiotic polyphenols increased the population of beneficial gut modulating bacteria while reducing the pathogens. Therefore, the study demonstrates the constructive collaboration of probiotic microbes and the purple tea bioactive compounds in the novel synbiotic yogurt in improving the healthful gut commensal bacteria. Future research can profile more commensal bacteria and analyze gut metabolites such as butyrate as well as conducting human clinical trials.Item Parenting Approaches on Children Food Uptake and Nutrition Status in Kiambu County, Kenya(EANSO, 2024) Mutuura, Caroline Hilda Karambu; Kigaru, Dorcus Mbithe; Ndung’u, Zipporah W.Parental use of reward and punishment is a key to reinforcement or deterrence of food choices among children an aspect that affects nutritional status throughout an individual’s life span. Kenya has a population of 47,564,296 people according to demographic survey of Kenya 2019, of whom 1.4 % are school-going children aged 6-years in Juja Sub-County of Kiambu, (Kenya National Beural of Statistics,2019). Cross-sectional analytical research design was adopted on 384 parent-child pairs, who were disproportionately sampled. Researcher-administered questionnaires were used to collect data. SРSS software version 26.0 was used to analyse the data with significance p<.05. Anthropometry data was analysed using WHO Anthro-Plus Survey Analyzer and compared to BMI-for-age (BAZ), weight-for-age (WAZ) and height-forage (HAZ) Scores for the target population. Pearson’s correlation (r) was used to establish association. Boys were 48.0% while girls were 52.0% with a mean age of 6.4± 0.1. Almost half the index children (45.1%) were born first. Mean household size was 5.0± 1.66 with maternal mean age at 34± 4.9 years and that of the fathers at 39± 4.8 years. The majority of mothers (73.0%) and fathers (76.1%) had tertiary level of education with more fathers than the mothers in the formal sector of employment, with a higher income. All (100%) children reported being rewarded by receiving incentives like praise words (60.1%), while majority of them (92.0%) reported being punished in multiple ways by the mothers when they refused to feed yet a third of fathers (61.0%) praised and gifted their children to feed. Prevalence of stunting (6.9%), underweight (7.1%), wasting (7.2%), overweight (16.4%) and obesity (11.7%) was observed in the study population. A positive strong significant relationship (p=0.05, x2=5.2) between age of the mothers and punishment was noted, also shouting threats, grounding, inflicting pain & withdrawal of privileges (p=0.05, x2=9.6) was common among the married mothers. More parents with tertiary education (74.6%) and higher incomes (40.5%) gifted and gave special permissions which had a stronger positive relationship to food choices (p=0.06, x2=4.33) and nutritional status (p=0.04, x2=5.9). Food choices had a strong positive relationship to nutritional status (p=0.05) and so did dietary diversity (p=0.6). Majority of the parents reported that the demographic characteristics (83.8%) and Socio-economic characteristics (90.7%) affected their food choices as a household. Almost all mothers (98.8%) and more than half of the fathers (55.4%) felt that rewarding and punishing the study children in relation to food had an effect on their food choices and approaches.Item Influence of Nutrition Knowledge on Dietary Practices and Attitudes of Pregnant Women in Migori, Kenya(Global Research Journal of Public Health and Epidemiology, 2020) Odiwuor, Florence. O.; Kimiywe, Judith; Waudo, JudithNutrient related deficiency diseases and micronutrient deficiencies which can result to intrauterine growth retardation are manifested. Approximately 200 million women become pregnant each year in developing countries and many of these women suffer from ongoing nutritional deficiencies. In Kenya, malnutrition primarily affects pregnant and lactating women and children under five years of age, and significantly contributes to their morbidity and mortality. Kenya’s high rates of under nutrition among WRA are particularly due to insufficient awareness and knowledge on nutritionally adequate diets among other causes. Nutrition education during pregnancy can improve dietary intake. This study sought to determine nutrition knowledge and practices on dietary intake and their associations before and after a psycho-educational nutrition initiative among pregnant women in Migori County. A prospective cohort study design was used and simple random sampling was used to obtain a sample of 150 pregnant women from three sub-county hospitals purposively selected for study. Pregnant women of GA ≤26 weeks were recruited and enrolled into psycho-educational nutrition intervention study. Data was collected by a nutrition knowledge and practices questionnaire. Data was collected at baseline and after intervention for each woman and analyzed by SPSS. Data was summarized by descriptive and relationships between variables was tested by Chi square. Findings showed that the pregnant women Nutrition education had positive significant associations with nutrition knowledge and practices. The study found significant effects of nutrition knowledge from the psycho-educational initiative on dietary intake. The study concludes that nutrition education can be used to improve behaviours and dietary practices of pregnant women. The finding is important to central and county governments, civil society, intergovernmental agencies, research groups, business enterprises and community under study.Item Dietary Practices and Dyslipidemia in Child Bearing Women in Nairobi City County Kenya: A Cross-Sectional Study(ajol, 2020) Obimbo, Matilda Makungu; Kimiywe, Judith; Ogada, Irene; Lodenyo, HudsonCardiovascular disease was one of the leading causes of mortality globally, more so in developing countries. The documentation on determinants and predictors for the cardiovascular disease biomarkers among childbearing women in Sub-Saharan Africa was wanting. Despite the growing burden of Non -Communicable Diseases, Dietary Practices and Dyslipidemia seemed to be a major factor of the disease. Objective: The study aimed at establishing the association between determinants and predictors for cardiovascular disease biomarkers particularly Dietary Practices and Dyslipidemia in Child Bearing Women in Nairobi City County, Kenya. Materials And Methodology : A household-based cross-sectional study was conducted among 252 women of age 15-49 years. In Two-stage cluster sampling 252 households in 18 clusters (estates) of Mugumoini ward Langata sub-county, Nairobi County were recruited. In the first stage, 252 households were divided into 18 clusters. In the second, random sampling was used to select 14 households per cluster. Kish grid method was used to select the eligible participant to be interviewed in each household. Those eligible had been residents of Mugumoini ward in the previous 12 months. Excluded were pregnant, lactating women, those in school and others with documented medical conditions including cardiovascular disease. A pretested researcher - administered questionnaire was used to collect information on socio-economic characteristics, saturated fat intake and determinants of food choice. A researcher administered questionnaire collected data for three months from 42 women. Fasting venous blood collection was done using 21 gauge needle then transferred into a coded vacutainer tube for transportation to the laboratory in three hours at room temperature. Blood was allowed to clot and separated into serum or cells. Lipid profile assays; total cholesterol, HDL- C, LDL-C and triglycerides were analyzed from serum in automated spectrophotometer Dirui CS 4000 validated by WHO. The participants in the pre-testing did not participate in the main study. Quantitative data collected was analysed using Statistical Package for Social Sciences version 22.0. Logistical regression, Chi-square and Odds –ratio were performed. Results : Lipid profile level; total cholesterol below 4 mmol/L, LDL-C below 1.80 mmol/L, HDL- C above 1.49 mmol/L and triglycerides below 1.70 mmol/L were all considered normal [53, 13] A third (34%) of the respondents was employed in offices and 60.8% accessed food from supermarkets and fast food outlets. While 41.2% were of the upper- middle class, thus increasing the risk to cardiovascular disease. Respondents consumed more energy-dense nutrient-poor diets characterized by saturated fat intake. Drivers of food choice were; Sensory appeal (95.6%), Emotional reasons (mood) (97.2%) and Convenience (77.2%). Conclusion : Almost half of the participants had high LDL-C and low HDL-C. Transitional diets were significantly associated with biomarkers for elevated LDL-C. Socio-economic characteristics (level of education, Occupation, Source of food, Upper-middle-class, Office work and Bachelor’s degree education level) were significantly associated with transitional diets. The odds of determinants for cardiovascular disease were four times (OR 3.66, 95% CI) likely as a predictor of dyslipidemia among childbearing women. Recommendation: We recommend all the stakeholders, Ministry of Health, both at county and national level to enact a law in support of interventions that promote low-fat foods and physical activities to improve cardiometabolic health. Individually 'Control Poor Dietary Practices avoid Dyslipidemia'Item Mothers’ Perceptions On and Learning from Infant and Young Child-Feeding Videos Displayed in Mother and Child Health Centers in Kenya: A Qualitative and Quantitative Approach(Cambridge University Press, 2021-05) Schneider, Lauriina; Kosola, Mikko; Uusimäki, Kerttu; Ollila, Sari; Lubeka, Crippina; Kimiywe, Judith; Mutanen, MarjaObjective: The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). Design: A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. Setting: The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. Participants: Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. Results: The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. Conclusions: Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in KenyaItem Feasibility of Delivering Vitamin a Supplementation (VAS) and Deworming Through Routine Community Health Servicesin Siaya County, Kenya: A Cross‐Sectional Study(Maternal & Child Nutrition, 2024-01) Ochola, Sophie; Lelei, Asa; Korir, Julius; Ombat, Caleb; Chebet, Caroline; Doledec, David; Mutea, Fridah; Nielsen, Jennifer; Omariba, Solomon; Njeri, Esther; Baker, Melissa M.Vitamin A deficiency and soil‐transmitted helminth infection are serious public health problems in Kenya. The coverage of vitamin A supplementation and deworming medication (VASD) provided through mass campaigns is generally high, yet with a cost that is not sustainable, while coverage offered through routine health services is low. Alternative strategies are needed that achieve the recommended coverage of >80% of children twice annually and can be managed by health systems with limited resources. We undertook a study from September to December 2021 to compare the feasibility and coverage of VASD locally delivered by community health volunteers (CHV) (“intervention arm”) to that achieved by the bi‐annual Malezi Bora campaign event (“control arm”). This comparative cross‐sectional study was conducted in sub‐counties of Siaya County using both qualitative and quantitative methods. VASD were offered through the CHS in Alego Usonga and through Malezi Bora in Bondo Sub‐County. Coverage was assessed by a post‐event coverage survey among caregivers of children aged 6–59 months (n = 307 intervention; n = 318 control). Key informant interviews were conducted with n = 43 personnel across both modalities, and 10 focus group discussions were conducted with caregivers of children aged 6–59 months to explore knowledge, attitudes and perceptions of the two strategies. VAS coverage by CHV was 90.6% [95% CI: 87.3–93.9] compared to 70.4% [95% CI: 65.4–75.4] through the Malezi Bora, while deworming coverage was 73.9% [95% CI: 69.0–78.7] and 54.7% [95% CI: 49.2–60.2], respectively. With sufficient training and oversight, CHV can achieve superior coverage to campaigns.Item Nutritional Composition and Anti-Nutrient Levels in Raw and Processed Varieties of Finger Millet Promoted for Nutritional Security(Scientific Research Publishing Inc, 2023) Nyabuti, George; Nawiri, Mildred; Wanzala, Everlyne; Munga, Judith; Oduori, Chrispus; Kinyuru, John; Nyambaka, Hudsoninger millet (FM) is rich in nutrients such as minerals, vitamins, and amino acids. However, the levels of nutrients and their bioaccessibility depend on the variety, the levels of ant nutrients, the chemical form of nutrients, and the type of processing methods used. The study determined the levels of selected nutrients, anti-nutrients, and bioaccessibility in raw and processed varieties of finger millet being developed by the Kenya Agricultural and Livestock Research Organization (KALRO) in Kenya. Raw finger millet seeds from KALRO Centers in Kenya were processed by malting for 60 hours and roasting at 110°C for 5 minutes as the optimal conditions. Levels of minerals were determined by AAS and AES, anti-nutrients by UV-visible spectrophotometer, proteins by the Pierce kit method, and vitamins by HPLC. The IE4115 and IE3779 showed the highest levels of nutrients and lowest levels of antinutrients hence preferred for processing and bioaccessibility studies..........Item Consumption Pattern of Tea is associated with Serum Ferritin Levels of Women of Childbearing Age in Nandi County, Kenya: A Cross-sectional Study(S. Karger AG, Base, 2024) Nyakundia, Patrick Nyamemba; Kiio, Juliana; Munyaka, Ann Wambui; Galgalo, Dahabo Adi; Lohner, SzimonettaIntroduction: Tea consumption with meals affects iron absorption increasing the risk of iron deficiency. Our study investigated the association between tea consumption patterns and serum ferritin levels among women of childbearing age (WCA) in Nandi County, Kenya. Methods: We conducted a cross-sectional analytical study among 160 WCA selected using a systematic random sampling technique from Kapsabet Ward. Information on tea consumption practices was gathered using a researcher-administered questionnaire, and serum ferritin and C-reactive protein were measured. We assessed associations between tea consumption and iron status of respondents by multivariable regression analysis, adjusting for potential confounders, including parasitic infections and recent severe blood losses. Results: The prevalence of anaemia and iron deficiency among the study participants were 86.2% and 45%, respectively. Majority (90.6%) of the respondents consumed tea or coffee, with an infusion time of more than 5 minutes (60.0%) and a moderate tea strength (64.1%), within 1-hr before or after meals. Iron deficiency was associated the number of teacups consumed (adjusted odds ratio = 7.282, 95% CI = 3.580-14.812). Conclusion: High tea consumption is positively associated with iron deficiency among WCA. Lower tea infusion strength, shorter tea infusion duration, and a lower number of teacups overall consumed, as well as consuming tea one hour before or after meals instead of with meals may be recommended for better outcomes in iron status among WCA.Item Influence of Resource Capabilities on Performance of Large Dairy Firms in Kenya(IJBM, 2018-03) Chege, Peter M.; Kiiru, GraceDairy industry, just like other firms focus to achieve high performance. This study aimed at assessing the influence of resource capabilities on performanceof large dairy firms in Kenya. A descriptive research design was adopted for this study. This study targeted a sample of 244 senior and middle level management staff from large dairy. An interview schedule was used to collect information on generic strategies and performance indicators. Tools were tested for validity and reliability. Data were analyzed using SPSS software by use of descriptive statistical and inferential methods. Pearson correlation was used to establish the relationship between study variables. Findings show that effective transport system and storage facilities improved firm’s performance, through increased production due to presence of storage and fast movement of goods to consumers as a result of effective transport system. All these led to improved performance through increased market share, low customer response rate and improved efficiency. In conclusion, resource capabilities are integral in enhancing performance. Thus, it is recommended that dairy firms need to focus on resource capacity especially of storage and transport to increase performance.Item Water Safety Practices and Occurrence of Diarrhea Among Children Under Five in Different Households of Njemp Community, Baringo County, Kenya(IISTE, 2019) Waruguru, Phyllis; Chege, Peter M.Water safety and quality is a key component in public health. Despite substantial progress made during the last decades, 11% of the global population are still not accessing adequate clean water and only 64% are able to access improved sanitation. Household water treatment methods, such as boiling or chlorination, have long been recommended in developing countries. Diarrhea diseases cause major public health problem in children underfive years of age, in addition, Water safety practices has been shown to affect health status. More research has focused on information about water safety practices at household level with minimal information on the relationship between water safety practices and occurrence of diarrhea among children below 5 years. This study was carried out to outline the occurrence of childhood diarrhea in relation to water safety practices. The study adopted a cross-sectional study design. This was among Njemp community in Baringo County, Kenya. Assessed was the household socio-demographic characteristics, sources of water, methods of domestic water treatment and the prevalence of diarrhea. Four hundred and twenty-two (422) households were targeted. However, data is reported for 401 households. Data was collected using a semi-structured questionnaire also the laboratory water analysis from different sources and treatment methods was done to determine the level of E. coli. Analysis was carried out using SPSS software. Chi-square was used for categorical variables while Pearson’s correlation coefficient was used for non-categorical variables to show the association between water safety practices and occurrence of diarrhea. Results show that majority of mothers (50.6%) were of age 26 – 35 years and married (78.3%). There was no significant difference in the mother’s various ages. The study also notes that most of the respondents (46.9%) had education up to primary level. Findings from household income indicates that majority of households earned less than Ksh. 10,000. River was the main source of water (50.6%). A few (31.2% and 18.2%) used borehole and rainwater respectively. The study found that river was the most contaminated source of water (50 MPN/100 mL) which was unsafe for human consumption according to WHO classification. On water treatment, majority (37.2%) used Moringa oleifera seeds for water treatment which acts as a natural absorbent and antimicrobial agent. 20.9% did not treat their water. The prevalence of diarrheal was 57.6%. There was a significant relationship between the water safety practices and occurrence of diarrhea. This study concludes that water safety practices of the Njemp community was low and as thus led to increased occurrence of diarrhea. This study recommends to the County Government of Baringo to come up with a centralized water treatment plant or dig boreholes and supply water to the people in Baringo County.Item Dietary Practices, Morbidity Status and Nutritional Status of People Living With Hiv/aids in Homabay County, Kenya(IJMSHR, 2018) Chege, Peter M.; Mokono, NaomAbstract Untreated infections have been observed to lead to malnutrition among People living with HIV/AIDS (PLWHAS). The purpose of this study was to explore how dietary practices affect the nutritional and morbidity status of PLWHAS. A cross-sectional study was undertaken to establish the dietary practices and sickness status of 321 randomly selected PLWHAS (aged 18- 55 years) in Homa Bay town, Kenya. Findings show a mean individual dietary diversity score of 3.72±0.11. On average the study population consumed a mean of 2.89±0.03 meals a day inclusive of snacks. About 26% of the study population failed to meet their recommended daily allowance for energy. More than 20% of the respondents failed to meet their minimum daily micronutrient requirement for iron, zinc, vitamin A and vitamin C. Great disparities were noted in the consumption of energy, protein, vitamin B2, iron and zinc between males and females. Results showed that >50% of the study population consumed only three (cereals, oils & fats, sugars) out of twelve food groups more than three times in seven days. About 55% PLWHAs were sick, malaria being the most prevalent disease affecting 76.8%. About 20% of the respondents were found to be undernourished. Therefore PLWHAS in urban areas of Kenya are bound to exhibit poor nutritional status due to poor dietary practices; denoted in this study by inadequate nutrient intake and reduced number of meals. Results also confirmed inadequate dietary practices given by the low frequency of consumption of selected food groups per seven days.Item Stakeholders’ Perceptions of the Nutrition and Dietetics Needs and the Requisite Professional Competencies in Uganda: A Cross-Sectional Mixed Methods Study(springer nature, 2021) Kikomeko, Peterson Kato; Ochola, Sophie; Kaaya, Archileo N.; Ogada, Irene; Birungi, Tracy Lukiya; Nakitto, PeaceAbstract Background: Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders’ perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor’s degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda. Methods: A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor’s degrees in HN/HND obtained from the Makerere and Kyambogo Universities in 2005–2016; 14 academic staff that train HN/HND in the two universities; and 11 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey; data from other participants was through face to face interviews using researcher administered questionnaires. Results: Most HN/HND respondents (84.8%) obtained their Bachelor’s degrees from Kyambogo University; 61.4% graduated in 2013–2016. Most (64.3%) academic staff respondents were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges cutting across different Sustainable Development Goals. The nutrition and dietetics interventions requested for, provided, and considered a priority for communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main competency domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research; and advocacy, communication, and awareness creation. Conclusions: This study shows that nutrition and dietetics challenges in Uganda are multiple and multifaceted; HN/HND graduates are employed in different sectors, provide nutrition-specific and sensitive services in a multisectoral environment, and are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps in some of the areas they are expected to exhibit competency. We recommend using these findings as a basis for obtaining stakeholder consensus on the key competencies that should be exhibited by all HN/HND graduates in Uganda; developing a HN/HND competency-based education model and a national HN/ HND training and practice standard; and undertaking further research to understand the quality and relevancy of HN/HND curricula to Uganda’s job market requirementsItem Comparison of Knowledge, Attitudes and Practices on Exclusive Breastfeeding Between Primiparous and Multiparous Mothers Attending Wajir District Hospital, Wajir County, Kenya: A Cross-Sectional Analytical Study(ibj, 2018) Mohamed, Mahat Jimale; Ochola, Sophie; Owino, Victor O.Background: Exclusive breastfeeding (EBF) is recommended for 6 months of age, with continued breastfeeding for 2 years of age or beyond. There is paucity of information on the disparity in Knowledge, Attitudes and Practices (KAP) on EBF between primiparous and multiparous mothers. This study compared the KAP on EBF between primiparous and multiparous mothers attending Wajir County Hospital, Wajir County, Kenya and investigated the association between maternal knowledge and attitudes and EBF. Methods: Information on maternal KAP on EBF was collected through structured researcher administered questionnaires for a total of 281 mothers, recruited from a maternal and child health centre in 2014; primiparous (n = 137) and multiparous (n = 144) with infants 0–5 months of age. Maternal knowledge and attitudes on various aspects of breastfeeding were determined. The knowledge and attitude scores were also calculated. The practice of EBF was determined based on a 24-h recall. Results: The prevalence of EBF among infants 0–5 months old was 45.5%. The rate of EBF among primiparous mothers was 39.4% and multiparous mothers 49.3%. The knowledge score on breastfeeding (out of a total of 10) for the primiparous mothers was 7.93 ± 2.10 and 7.49 ± 2.20 for the multiparous mothers. The mean attitude score (out of a total score of 40) for the primiparous mothers was 29.46 ± 5.65 and 28.65 ± 6.40 for the multiparous mothers. The prevalence of EBF and maternal knowledge and attitudes towards breastfeeding was similar among the two groups of mothers. Those mothers with positive attitudes towards breastfeeding were more likely to EBF (Fisher’s exact test; p = 0.00) compared with those with lower scores. Conclusions: Interventions to promote exclusive breastfeeding should be tailored to the needs of each population by identifying the factors that influence the practice in a given context. The findings of this study will be useful particularly for behavior change communication interventions by those organizations working in similar circumstances to the study area.Item Zinc Bioaccessibility in Finger Millet Porridge Blended with Zinc-Dense Mushroom(Cell Press, 2023) Karenya, S. Luvitaa; Munyaka, A. Wambui; Musieba, Fredrick C.; Ojwang, D. OtienoIntroduction: Zinc deficiency is a common health problem among people who rely heavily on cereal-based foods. Consequently, most people from low-income families, particularly young children in Sub-Saharan Africa, who rely mainly on cereal-based meals, have suffered from Zinc deficiencyrelated health issues. It is therefore recommended that children who show signs of zinc deficiency like poor growth and cognitive impairment be fed zinc-rich meals; however, in severe cases, they should be given zinc supplements to reduce risks of morbidity and mortality. In that regard, since edible mushrooms are nutritionally rich and contains essential minerals as well as health-promoting compounds, they are a promising tool for improving the nutritional and health quality of commonly carbohydrate-rich foods. Objective: The objective of this study was to examine the Zinc bioaccessibility and sensory properties of HMT finger millet porridge blended with Zinc-dense mushroom. Methods: Oyster mushroom (Pleurotus ostreatus) was grown on rice straw enriched with zinc sulfate at various concentrations. After reaching full maturity, the mushrooms were harvested, dried, and milled into a fine powder. Zinc-rich mushroom powder was mixed with millet flour in various proportions and used to prepare porridge. The zinc bioaccessibility in millet-mushroom flour blends was determined using a simulation method of gastro intestinal digestion. In addition, panelists comprising of mothers and caregivers of children aged between 6 and 23 months were asked to evaluate the sensory attributes of millet-mushroom porridge. Results: Adding Zinc to growth substrates had a significant (p˂0.05) effect on mushroom yield. Control substrates without Zinc yielded 120 g of mushroom per kilogram substrate. However, when 100 mg Zinc was added to the substrate, the yield increased by 65.6%. The study further noted that substrates with Zinc beyond 100 mg had a negative effect on mushroom yield. Consequently, substrates with the highest Zinc level (600 mg) produced the lowest mushroom yields. Increasing substrates Zinc content, on the other hand, had positive effect on mushroom Zinc levels. Substrates without Zinc produced mushrooms containing 8.9 mg Zinc, which increased by 30.9% when 600 mg Zinc was added. Furthermore, HMT finger millet porridge without mushrooms had a phytates: Zinc molar index of 60.3, which decreased to 34 when 20% (w/w) mushroom proportions were added. Despite having the highest bioaccessible Zinc with the least effect on texture and appearance, a 20% mushroom proportion in HMT finger millet porridge considerably compromised the taste, aroma and general consumer acceptability. Conclusion: Amending HMT finger millet flour with mushroom powder improved Zinc bioaccessibility of the porridge. However, when added beyond a certain limit, mushroom reduced organoleptic qualities of the porridge, which affected overall consumer acceptance. The study recommends, therefore, that mushroom powder be added to finger millet flour in the appropriate proportions to enhance nutritional and health benefits of porridge while minimizing possible negative impacts on sensory properties.