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The triple burden of malnutrition is a problem that is being fought against at global, continental, regional and national levels. When consumed in adequate quantities, healthy diets are important in reversing the menace of malnutrition. In Kenya, grains are an important source of energy and micronutrients. Even though they contribute most energy and micronutrients, a huge Recommended Daily Allowance deficit still exists. Incorporating ancient grains such as quinoa which are nutrient-rich and can survive in harsh climatic zones into the diets, can boost the efforts made towards the fight against malnutrition. Though quinoa adaptation trials have been conducted in Kenya, expanded data on the nutrient content are yet to be compiled. Between May 2022 and August 2022, four varieties of quinoa; Cherry Vanilla, Titicaca, Brilliant Bright Red and Biobio were grown at the University of Nairobi, Upper Kabete campus field station. The harvests of the four varieties were separately analyzed to determine and compare the content levels of macronutrients (carbohydrates, crude protein, fats) and micro-nutrients (manganese, magnesium, potassium, calcium, iron, copper and zinc). The four varieties were significantly different in all the analyzed elements except moisture content. Cherry vanilla had the highest level of crude protein (25.1[+ or -]0.3g/100g) and fat (11.46[+ or -]0.184g/100g) but the lowest level of carbohydrates (42.5[+ or -]0.4%). Titicaca had the highest amounts of; manganese (21.9[+ or -]0.06g/100g), potassium (511.9[+ or -]0.03mg/100g), iron (11.5[+ or -] 0.07mg/100g) and zinc (14.1[+ or -]0.0mg/100g). Biobio variety exhibited the highest amount of magnesium (73.9[+ or -]0.1mg/100g). In conclusion, the different varieties of quinoa significantly differ in their levels of macro and micronutrients. The Kenyan-grown quinoa has the potential to contribute to increased dietary intake of both macronutrients and micronutrients of children aged 2-6 years old. The Kenyan-grown quinoa contains levels of micronutrients in higher amounts compared to maize, rice and wheat - the commonly consumed cereals in Kenya. On this basis, the study recommends that the growing and consumption of quinoa should be promoted in Kenya and introduced into the diets of children aged 2-6 years of age in Kenya. Quinoa-based products for children aged 2-6 years should be developed. Climate zone-oriented agronomic trials on quinoa farming should be conducted. Key words: Quinoa, varieties, Cherry Vanilla, BBR, Titicaca, Biobio, micronutrients, macronutrients, INTRODUCTION Over the past three decades, significant effort has been made to battle the triple burden of malnutrition which encompasses undernutrition, overnutrition and micronutrient deficiency. According to the Joint Child [...]

The prevalence of maternal undernutrition has been reduced via numerous interventions, but it remains a global public health concern in underdeveloped countries. Pregnant women are increasingly using mobile phone applications to obtain, save, and share health information. This study evaluated maternal nutrition knowledge for the purposes of developing a mobile phone application-based health information sharing platform for pregnant women attending ante-natal care at Kenyatta National Hospital in Nairobi, Kenya. The study adopted cross-sectional descriptive and analytical study design. A food frequency and individual dietary diversity questionnaires were used to gather data on dietary consumption and diversity, while a semi-structured questionnaire was used to gather sociodemographic information from respondents who attended the antenatal clinic. Approximately 31.2% of respondents exhibited a high level of knowledge regarding mobile phone applications. Half of the participants (50.1%) demonstrated a moderate level of understanding, whereas 18.7% showed a low level of familiarity with mobile phone applications. About 19.9% met the minimum dietary diversity score, while 12.2% met the minimum meal frequency, and 26.7% met the minimum acceptable diet. Based on Mid-Upper Arm Circumference, 60% of the pregnant women had normal nutritional status, 36.9% moderate acute malnutrition while 3.1% had severe acute malnutrition. Significant association was observed between dietary diversity score and mobile phone application knowledge p < 0.001. Additionally, nutritional status p < 0.05 and level of education p < 0.05, and mobile phone application knowledge of pregnant women showed significant associations. Despite the growing number of mHealth apps, the level of knowledge and usability of such apps by patients still remains relatively low. Nevertheless, the majority who used health apps found them to be beneficial, and agreed that it helped them to live a healthier lifestyle. Health apps have great potential in health promotion and therefore, to increase the use of these apps, it is necessary to first increase awareness and knowledge of these apps, both to the public and to healthcare professionals. Key words: Mobile phone application knowledge, Maternal nutrition status, Maternal Diet, INTRODUCTION Globally, maternal malnutrition remains a significant public health concern in developing countries, prompting the implementation of various interventions that aim at reducing its prevalence [1]. Evidence suggests that effective [...]

Varied nutrient-dense and high-quality diet are key to ideal growth and cognitive function in the early years of life. Nutrient deficiency can lead to negative functional effects of the brain and poor cognitive function. High rates of poverty in developing countries predispose children to malnutrition. This study aimed at exploring factors associated with dietary intake and cognitive development among children in Kisumu County, Kenya. This was a cross-sectional study survey that recruited 192 children aged less than 24 months. Food frequency questionnaire and Bayleys Scale for Infant Development kit was used to collect data. It was revealed that a total of 51% were girls with 30% aged below 6 months. Only 12% had cognitive scores above average. Child cognitive scores were linked with age (p= 0.022), carbohydrate (p=0.021), fat (p=0.011) and iron (p=0.022) intake. Only 34% and 32% of children consumed diets adequate in proteins and iron, respectively. Of children aged above 18 months, only 13% consumed diet adequate in iron. Factors associated with carbohydrate intake included: mother's marital status (p=0.036) and her level of income (p=0.028) while protein intake related to the type of housing (p=0.013). Fat intake was linked with the mother's marital status (p=0.009) and her level of income (p=0.001) while the iron intake was linked to the mother's level of income (p= Key words: Dietary intake, Cognitive development, Children, Bayleys Scale for Infant Development, Malnutrition, INTRODUCTION Good nutrition in the early years of life is key for ideal growth and cognitive development. A varied nutrient-dense diet has a direct link to growth, immunity, cognitive function [...]

Background: Malnutrition is one of the leading causes of maternal and young child mortality in underdeveloped countries, particularly during pregnancy and delivery. The effects of malnutrition in pregnant women include low birth weight, preterm birth, intrauterine growth restriction, nutrient deficiencies and reduced breast milk production. Mobile phone applications are widely used with features such as portability, ease of communication, storage at relatively low cost that makes such technology attractive to nutritionists. Objective: To assess if mobile phone applications can be beneficial in maternal and young child malnutrition intervention. Methods: Zotero reference management software was used to ensure the rigor and reproducibility of the review process. Based on defined key words, a search was conducted on Google Scholar, ScienceDirect, PubMed and Springer databases to retrieve all publications on mobile phone applications in maternal and young child malnutrition interventions. The study used ten articles from unique studies that met the study criteria and are reported in terms of authors, year, sample size, study design and outcome measure. Results: The articles revealed that mobile phone applications were highly useful in maternal and young child malnutrition intervention, prompting nutrition information seeking and facilitating communication with healthcare providers. Conclusion: Mobile phone applications are widely acknowledged, and beneficial in maternal and neonatal malnutrition management, they have the potential to improve maternal and young child nutritional status through self-monitoring. Given the low uptake of current mobile phone application, it should be given a significant consideration as a potential strategy for managing maternal and young child malnutrition. [ABSTRACT FROM AUTHOR]

A survey was carried out to document the diversity and immune boosting claims of African indigenous leafy vegetables (AILVs) in Western Kenya. Both qualitative and quantitative methods of data collection were used. The results showed that there is diversity of AILVs in the study area with nine popular and frequently consumed, but cassava leaves, stinging nettle and russian comfry are not popular. Seven of these are cultivated but two, stinging nettle (Urtica massaica) and vine spinach (Basella alba) grow wildly. The AILVs are cultivated at subsistence level on home gardens with minimal inputs and only excess of this is sold. The religion one belonged to was significant (p < 0.05) in determining consumption or not of some of the vegetables. The vegetables are rain fed and the process of harvesting is by first uprooting during thinning followed by breaking the main stem and finally plucking off the leaves with maturity. Vegetable preparation in most households was mainly by women. The elderly women were keen in this process and spent more time in preparing the vegetables which were believed to be 'nutritious'. There was no processing and preservation of the AILVs for use during the dry season. The communities rely on wild weeds during such seasons. The AILVs though consumed for good nutrition are also associated with various medicinal and immune boosting claims. Out of the nine, five are known for various health benefits, African nightshade and spider plant for good nutrition by 31.8% and 25.1% of the respondents, respectively, slender leaf for healing power by 34%, cowpea leaves and slender leaf for anti-aging by 50% and 43.8%, respectively, and cowpea leaves (43.6%) and amaranthus (53%) for smooth skin and adding blood, respectively. Chi square analysis indicated that African night shade, spider plant and amaranthus are statistically significant (p Key words: indigenous vegetables, diversity, immune boosting, INTRODUCTION The definition of vegetables varies from culture to culture depending on food selection and preparation [1]. Different vegetables have different edible parts, for example flower buds (broccoli, cauliflower), seeds [...]

Wasting, categorized as either severe or moderate, is a form of child malnutrition that manifests with a low weight-for-height Z-score. Previous treatment methods for moderate wasting, which affects approximately 300,000 children in Kenya, were ineffective as they lacked a mechanism to replace the accelerated loss of lean tissue. Supplementation with leucine, may be a safe and effective method for treating moderate wasting. At a high dosage, leucine activates the mammalian target of rapamycin within the muscles which enhances gain of lean tissue. Leucine supplements are currently inaccessible to populations affected by moderate wasting in Kenya. The objective of this study was, therefore, to formulate a leucine-rich composite flour (TheraPEM) from locally available foods for treatment of moderate wasting. Six composite flours were prepared using combinations of beans (Phaseolus vulgaris), groundnuts (Voandzeia subterranea), and foxtail millet (Setaria italica) selected for their high leucine content, local availability and relatively low cost. Nutrient composition analysis and sensory evaluation were conducted on each of the six flours. The three preferred flours in terms of sensory attributes were subjected to accelerated shelf-life evaluation to determine changes in peroxide value, fat acidity, moisture content and total viable count. Kraft paper, gunny bags and plastic containers were the packaging materials used. All six flours met the Codex Alimentarius food standards for minimum energy density (80 kcal/100g) and maximum fat content (27 %) in processed cereal-based foods used for complementary feeding of infants and young children. They all also met the required > 1050 mg leucine per 100 grams of flour. Formulations 2, 3 and 5 had the most preferred sensory attributes and were thus subjected to accelerated shelf-life evaluation. At the fifth month, fat acidity was least in the flours packaged in plastic containers. There was no peroxide formation in any of the three samples during the storage period. The study generated six formulations that meet the minimum requirement for leucine in treatment of moderate wasting but formulation 3, had the most preferred sensory attributes. It is recommended that formulation three be subjected to a study to further validate its effectiveness in the treatment of moderate wasting prior to release for up-scaled use. [ABSTRACT FROM AUTHOR]

Traditional indigenous vegetables are the most economically efficient source of micronutrients in terms of both land required and production costs per unit. Promotion of production and consumption of such micronutrient-rich foods will improve intakes, the overall diet, and health status. This study aimed to determine nutrient (iron, calcium, vitamin A and ascorbic acid) and anti-nutrient (oxalates and polyphenols) contents in raw, cooked and dried sweet potato leaves Two varieties of sweet potatoes, which were identified as commonly grown for leaves consumption were analyzed at Department of Food Technology, Sokoine University of Agriculture and at the Government Chief Chemist Laboratory Tanzania. The analysis included proximate, nutrient (ascorbic acid, carotenoids, iron and calcium) and anti-nutrient (oxalate and polyphenols) composition. The purple midrib sweet potato leaves were further analyzed for nutrient and anti-nutrient retention after cooking (with and without lemon) and open sun-drying (with and without salting). There was no significant difference (P>0.05) between the two varieties in crude protein, crude lipid and moisture content. The purple midrib sweet potato leaves had significantly (P Key words: Sweet potato leaves, nutrients, antinutrients, INTRODUCTION Sweet potato (Ipomoea batatas L) is grown as a food crop in most parts of the world, mainly for root production. Consumption of leaves as a vegetable is only [...]

About 25.4 million people worldwide are living as refugees of whom 1.36 million are in Uganda. The refugees in this study were from South Sudan. The objective of this study was to determine the nutrition status of the refugee children and elucidate the factors that contribute to poor nutrition status among the host. The study used comparative analytical cross-sectional design on 340 children aged 6-59 months. The overall prevalence of global acute malnutrition was 3.9%, underweight 14.1%, and stunting 24.7%. Five factors contributed to poor nutrition status; household size (OR a 1.34, 1.92), illness in wasted, stunted and underweight (OR a 1.47, 1.49, 1.97) children, being a host in relation to wasting and stunting (OR a 1.81, 1.36) and deworming (OR a 3.2, 2.13). Although the host had good nutrient intake, the refugee children had better nutrition status. Therefore, the Uganda government should formulate a policy that allows the host to benefit equally from food relief during emergencies., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Nutritional deficiencies are common during pregnancy and a year after childbirth. At the same time, maternal depression affects many women during pregnancy up to 1 year after childbirth. The objectives of this study were to determine the associations between nutrition status, dietary intake, and maternal depression among pregnant women., Methods: This was a cross-sectional study that included 262 pregnant women aged 15 to 49 years attending the antenatal clinic in 2 public health facilities in urban low-income settlements in Nairobi, Kenya. Maternal depression was assessed using Edinburgh Postnatal Depression Scale (EPDS). Mid-upper arm circumference (MUAC) was used to determine nutritional status. Dietary intake was assessed using the 24-hour recall, and brain essential nutrients were assessed through a questionnaire. Odds ratio was used to test the associations. All maternal characteristics with P < .001 in the univariable analysis were considered in the multivariable logistic regression, variables with P < .05 were considered significant., Results: Of the 262 pregnant women, 33.6% (95% CI: 27.9-40.7) had depressive illness as indicated by EPDS >13. About 9.9% of pregnant women had MUAC < 23 cm. The study established statistically significant association between poor nutrition by MUAC and maternal depression ( P < .001). Maternal depression was statistically significantly associated with inadequate intake of brain food essential ( P = .002). Maternal depression was statistically significantly associated with lower income ( P < .001). In multivariable regression analysis, the main predictor of maternal depression was poor nutrition ( P < .004)., Conclusion: These findings reveal an association between poor nutrition and maternal depression. These results suggest that nutritional deficiencies could be a contributing factor for maternal depression. Study recommends dietary interventions as cost-effective way to reduce deficiencies and improve mental health problems for pregnant women. Assessment of maternal depression and dietary intake be integrated as fundamental components of antenatal care.

Background: Prepartum depression is common among pregnant women and has not been studied much in low and middle-income countries. Evidence shows that mental illnesses are more prevalent in urban than in rural areas. The study objective was to determine the magnitude of prepartum depression, risk factors, and real-life experiences of depression among pregnant women. Method: A mixed-method cross-sectional study was conducted. It included 262 pregnant women attending antenatal clinics in two public health facilities in the urban low-income settlement of Nairobi, Kenya. Edinburgh Postnatal Depression Scale (EPDS) with cut-off >13 was used to classify clinical depressive illness. Further, a focus group discussion was conducted with 20 women identified with the depression. Bivariate analysis with Odd's Ratio was used to test associations. Variables with a p<0.05 in multivariate were considered significant. Result: Out of the 262 women, 33.6% were found to have prepartum depression as indicated by an EPDS score of >13. Women's gestational age in the second trimester (87.5%) was statistically significantly associated with prepartum depression (p<0.001). Income levels <10,000 KES (58%) were statistically significantly associated with prepartum depression (p<0.001). Further, thematic analysis of qualitative data indicated that poverty, lack of social support, domestic violence, and unfriendly health care were major contributors to prepartum depression. Conclusion: Significant numbers of pregnant women were found to experience depression. This prevalence rate indicates a high disease burden of women who live with depression, which is not diagnosed because screening of depression is not done in primary health care centers. This study calls for a need and consideration for screening for perinatal depression in primary health care facilities, mainly in resource-poor areas. Interventions targeting means of resolving conflicts in families are highly needed. Such steps would help achieve key sustainable development goals where maternal and child health remains a key priority., Competing Interests: No competing interests were disclosed., (Copyright: © 2020 Madeghe BA et al.)

Background: Prepartum depression is common among pregnant women and has not been studied much in low and middle-income countries. Evidence shows that mental illnesses are prevalent in urban than in rural areas. The study objective was to determine the magnitude of prepartum depression, risk factors, and real-life experiences of depression among pregnant women. Method: A mixed-method cross-sectional study was conducted. It included 262 pregnant women attending antenatal clinics in two public health facilities in urban low-income settlement Nairobi, Kenya. Edinburgh Postnatal Depression Scale (EPDS) with cut-off >13 was used to classify clinical depressive illness. Further, a focus group discussion was conducted with 20 women identified with depression. Univariable analysis with Odd's Ratio was used to test associations. Variables with a p<0.05 in multivariable regression were considered significant. Result: Out of the 262 women, 33.6% were found to have clinical depression as indicated by EPDS score of >13. Women's gestational age was statistically significantly associated with prepartum depression [OR 4.27 (95% C.I. 2.08 - 8.79),  p < 0.001 ]. Income level ≤ 5000 KES was statistically significantly associated with prepartum depression [OR 3.64 (95% C.I.1.25 -10.60), p=0.018 ]. Further, thematic analysis of qualitative indicated that poverty, lack of social support, domestic violence, and unfriendly health care were major contributors to prepartum depression. Conclusion: Significant numbers of pregnant women were found to experience depression. This prevalence rate indicates a high disease burden of women who live with depression, which is not diagnosed because screening of depression is not done in primary health care centers. This study calls for a need and consideration for screening for perinatal depression in primary health care facilities, mainly in resource-poor areas. Interventions targeting means of resolving conflicts in families are highly needed. Such steps would help achieve key sustainable development goals where maternal and child health remains key priority., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Madeghe BA et al.)

Background: Globally, it is known that HIV-infected pregnant women are prone to depressive symptoms. Research evidences also suggest that nutrient deficiencies may enhance the depressive illness, and that fish oil omega-3 fatty acids may alleviate the depressive symptoms. The aim of this study was to assess the effect of fish oil omega-3 eicosapentaenoic acid-rich supplements on depressive symptoms among HIV-seropositive pregnant women., Trial Design: A randomized double-blinded controlled trial with two parallel groups was conducted. The intervention group received fish oil omega-3 of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) per day for 8 weeks, while the control group received soybean oil for a similar period., Method: Participants were HIV-seropositive pregnant women who were enrolled in prevention of mother-to-child transmission programs and attending antenatal clinics at selected Nairobi city county's health facilities. Recruitment was done from health records of HIV-infected pregnant women. Data analysis followed per-protocol analysis. Participants who completed the 8-week trial were included in the analysis of covariance statistical model with omega-3 as main effect. The covariates in the change in BDI-II depressive symptom score outcome were baseline characteristics and nutrient adequacy., Results: 282 participants were recruited 109 randomized to fish oil, and 107 to soybean oil. Completion rate was 86/109 (78.9%) and 96/107 (89.7%) respectively. At the end of week-8 of follow up most participants in both arms had mild depressive symptoms 82/86 (95.3%) in the Fish oil group and 94/96 (97.9%) in the Soybean oil group. The difference in effect between the intervention and control group was not statistically significant (1.01 (95% CI - 0.58 to 2.60), p  = 0.21)., Conclusion: Fish oil omega-3 with a daily dosage of 3.17 g (eicosapentaenoic acid = 2.15 g; docosahexaenoic acid = 1.02 g) appears to provide no added benefit in reduction of the symptoms of depression in HIV-infected pregnant women. Trial Registration Clinical Trial Registry: NCT01614249. Registered on June 5, 2012. https://clinicaltrials.gov/ct2/show/NCT01614249.

Streptococcus infantarius subsp. infantarius (Sii), a member of the Streptococcus bovis/Streptococcus equinus complex (SBSEC), predominates as dairy-adapted and non-adapted variants in fermented dairy products (FDP) in East and West Africa. Epidemiologic data suggest an association with colorectal cancer for most SBSEC members, including Sii from Kenyan patients. Phylogenetic relationships of East African human (EAH) isolates to those of dairy and pathogenic origin were analysed to better estimate potential health implications via FDP consumption. The MLST-derived population structure was also evaluated to provide host, disease, geography and dairy adaptation associations for 157 SBSEC isolates, including 83 novel Sii/SBSEC isolates of which 40 originated from Kenyan colonoscopy patients. Clonal complex (CC) 90 was delineated as potential pathogenic CC for Sii. Single EAH, West African dairy (WAD), food and animal Sii isolates clustered within CC-90, suggesting a potential link to pathogenic traits for CC-90. The majority of EAH and WAD Sii were clustered in a shared clade distinct from CC-90 and East African dairy (EAD) isolates. This indicates shared ancestry for the EAH and WAD clade and limitations to translate disease associations of EAH and CC-90 to EAD Sii, which could support the separation of pathogenic, pathobiont/commensal and food lineages.

Consumption of traditional fermented dairy products (tFDP) in Africa leads to the ingestion of up to 10 8 Streptococcus infantarius subspecies infantarius (Sii) per millilitre of spontaneously fermented milk. Sii is a member of the Streptococcus bovis/Streptococcus equinus complex (SBSEC) for which some members are associated particularly with colorectal cancer or endocarditis. The extent of health risks to tFDP consumers is largely unknown. A hospital-based unmatched case-control study was conducted at Kenyatta National Hospital, Nairobi (Kenya) on 80 cases and 193 controls that were selected exhaustively from patients attending colonoscopy at the hospital. Logistic regression models adjusted for age, sex and residency were used in the statistical analysis. Consumption of tFDP was not associated with CRC (odds ratio (OR) 1.4; 95% Confidence interval (CI) 0.7-2.7; p=0.34). Risk factors associated with CRC included age above 40 years, and consumption of processed meat and alcohol. Faecal carriage of Sii was significantly higher in persons with colon tumours and polyps compared to controls (8.4% vs 21.6%: OR: 4.6; CI 1.3-15.9). Patients with haemorrhoids represented an unexpected carrier group with significantly higher Sii faecal carriage (30.4%, CI: 17.7-45.8). Consumption of tFDP does not represent risk factors for CRC whereas Sii seems to be associated with CRC. However, there is urgent need to assess this finding also in the general population, investigate the causality of SBSEC, Sii and CRC as well as compare the phylogenetic, functional and genomic relationship between human and dairy Sii with regards to the ongoing application of Sii in FDP production., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

Milk is a major source of nutrients, but can also be a vehicle for zoonotic foodborne diseases, especially when raw milk is consumed. In Africa, poor processing and storage conditions contribute to contamination, outgrowth and transmission of pathogens, which lead to spoilage, reduced food safety and security. Fermentation helps mitigate the impact of poor handling and storage conditions by enhancing shelf life and food safety. Traditionally-fermented sour milk products are culturally accepted and widely distributed in Africa, and rely on product-specific microbiota responsible for aroma, flavor and texture. Knowledge of microbiota and predominant, technologically important microorganisms is critical in developing products with enhanced quality and safety, as well as sustainable interventions for these products, including Africa-specific starter culture development. This narrative review summarizes current knowledge of technologically-important microorganisms of African fermented dairy products (FDP) and raw milk, taking into consideration novel findings and taxonomy when re-analyzing data of 29 publications covering 25 products from 17 African countries. Technologically-important lactic acid bacteria such as Lactococcus lactis and Streptococcus infantarius subsp. infantarius (Sii), Lactobacillus spp. and yeasts predominated in raw milk and FDP across Africa. Re-analysis of data also suggests a much wider distribution of Sii and thus a potentially longer history of use than previously expected. Therefore, evaluating the role and safety of African Sii lineages is important when developing interventions and starter cultures for FDP in Africa to enhance food safety and food security. In-depth functional genomics, epidemiologic investigations and latest identification approaches coupled with stakeholder involvement will be required to evaluate the possibility of African Sii lineages as novel food-grade Streptococcus lineage., (Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The Streptococcus bovis/Streptococcus equinus complex (SBSEC) comprises seven (sub)species classified as human and animal commensals, emerging opportunistic pathogens and food fermentative organisms. Changing taxonomy, shared habitats, natural competence and evidence for horizontal gene transfer pose difficulties for determining their phylogeny, epidemiology and virulence mechanisms. Thus, novel phylogenetic and functional classifications are required. An SBSEC overarching multi locus sequence type (MLST) scheme targeting 10 housekeeping genes was developed, validated and combined with host-related properties of adhesion to extracellular matrix proteins (ECM), activation of the immune responses via NF-KB and survival in simulated gastric juice (SGJ)., Results: Commensal and pathogenic SBSEC strains (n = 74) of human, animal and food origin from Europe, Asia, America and Africa were used in the MLST scheme yielding 66 sequence types and 10 clonal complexes differentiated into distinct habitat-associated and mixed lineages. Adhesion to ECMs collagen I and mucin type II was a common characteristic (23 % of strains) followed by adhesion to fibronectin and fibrinogen (19.7 %). High adhesion abilities were found for East African dairy and human blood isolate branches whereas commensal fecal SBSEC displayed low adhesion. NF-KB activation was observed for a limited number of dairy and blood isolates suggesting the potential of some pathogenic strains for reduced immune activation. Strains from dairy MLST clades displayed the highest relative survival to SGJ independently of dairy adaptation markers lacS/lacZ., Conclusion: Combining phylogenetic and functional analyses via SBSEC MLST enabled the clear delineation of strain clades to unravel the complexity of this bacterial group. High adhesion values shared between certain dairy and blood strains as well as the behavior of NF-KB activation are concerning for specific lineages. They highlighted the health risk among shared lineages and establish the basis to elucidate (zoonotic-) transmission, host specificity, virulence mechanisms and enhanced risk assessment as pathobionts in an overarching One Health approach.

Objective: To identify the factors associated with childhood under-nutrition in North Wollo, Ethiopia., Design: A cross-sectional study., Setting: Four purposefully selected rural villages (kebeles) in North Wollo zone of the Amhara Region, Ethiopia., Subjects: One hundred-forty four sampled households with under five year old children (n=200) comprising of 96 male-headed, 24 female-headed and 24 landless with children aged between six and 59 months., Main Outcome Measures: Determinations of anthropometric measurements and various socio-economic factors., Results: The overall prevalence rate of under nutrition as determined by stunting, underweight and wasting was 44.5%, 25.0% and 9.0% respectively with more preponderance among the toddlers. The proportion of under nutrition was higher in female-headed households. Shortage of farmland, lack of irrigation, dispossession of livestock, shortage of non-farm employment options, parental illiteracy, high number of children, water inadequacy, food taboos and wrong eating habits of families, poor child feeding practices, deprivation of health nutrition education as well as maternal attributes such as young motherhood, low body mass index and short stature of mothers influenced the nutritional status of the children. The prominent risk factors for undernutrition among children were dispossession of livestock, child food taboos and wrong eating habits of families, deprivation of health/nutrition education, short stature and early marriage of mothers., Conclusion: This study led to the conclusion that improvement of household resources through promotion of irrigation and initiation of income generating livelihood options can reverse the nutrition situation for better. Health and nutrition education focusing on appropriate child feeding, eradication of harmful traditional practices such as early marriage and inequitable intra-household food distribution, encouragement of family planning and nutrition interventions including food diversification is recommended.

Objective: To evaluate the impact of daily and weekly iron supplementation on serum zinc status among anaemic lactating mothers., Design: A randomised iron intervention controlled trial., Setting: Seven urban slum communities of Addis Ababa., Subjects: Phase one of the study involved 207 anaemic lactating women assigned into two intervention groups; the daily (N=71) and weekly (N=71) Iron supplemented and the control group (N=68). Supplementation with 60 mg tablet containing 300 microg ferrous sulphate and 400 microg folic acid was done for three months while the control group was n otsupplemented. Phase two involved 53 participants systematically drawn from phase one., Main Outcome Measures: Haemoglobin from all subjects and serum zinc and ferittin levels following three months supplementation. Zinc status based on serum zinc value of less than 10.7% micromole/L., Results: The mean baseline characteristics and serum zinc of the women at baseline were similar, overall marginal zinc deficiency prevalence was 11.3% and no zinc deficiency was detected. Following supplementation, zinc deficiency was detected in the supplemented groups but not in the control group. The mean serum zinc significantly changed in both supplemented groups while no change was observed in the control group. The reduction in the mean serum zinc was significantly higher in the daily than in the weekly supplemented group., Conclusion: Iron supplementation impacts negatively on serum zinc status (exacerbates zinc deficiency) and hence, its contribution to zinc deficiency deserves further investigation especially in the context of the on-going promotion of double fortification strategies that involve iron.

A cross-sectional study was done from March to May 1997 in four selected slum kebeles (villages) of Addis Ababa in which nutritional status of 758 children aged 6 to 36 months was examined and stratified into malnourished and well nourished groups. Analysis of hygiene and health seeking practices of randomly selected households of the two sets of children determined practices that significantly exacerbate childhood malnutrition. The rates of immunization for the malnourished (80.2%) and well nourished households (77.6%) were practically the same. No significant difference was found in the prevalence of home treatment or food withholding habits at times of diarrhoea episodes between the two groups. The study established six variables to predict childhood malnutrition in the slum section of Addis Ababa: 1) presence of child waste inside house (Odds Ratio = 7.44; p < 0.0001), 2) diarrhoea treatment at the hospital (OR = 0.47;p < 0.05), 3) prolonged storage of cooked foods (OR = 2.86;p < 0.05), 4) feeding with washed hands (OR = 0.44; p < 0.01), and 5) poor handling of drinking water (OR = 3.18; p < 0.01) and 6) foods (OR = 3.52; p < 0.01). Hence strong and sustainable advice with a view of changing the behaviours of households towards good personal and household hygiene practices, and increased utilization of health settings is recommended as these may limit the overall success of public health programmes.

Most nutrition education programmes in Kenya operate on the premise that nutritional knowledge can have an impact on children's nutritional status. It has, however, been argued that nutritional knowledge among low income groups is unlikely to have an impact, hence, the need to establish whether there is a relationship between nutritional status and maternal nutritional knowledge. In a cross-sectional survey carried out in a Nairobi slum (Kibera), nutritional status of 363 children aged six to 24 months was measured and nutritional knowledge of their mothers assessed. Makina village was randomly selected as the study site and all consenting households were involved in the study. The study established that most mothers (97.5%) have access to nutrition education. Prevalence of stunting (86.2%) and underweight (58.4%) was high but that of wasting (1.9%) was low. There was no significant relationship between the nutritional status of children and overall nutritional knowledge. Unexpectedly, a negative relationship was found between nutritional status and mothers' ability to recognise clinical signs of malnutrition, knowledge in the weaning process and dietary management during sickness. Knowledge on frequency of feeding was, however, positively related to nutritional states. In conclusion, nutritional knowledge alone is inadequate in ensuring young children's nutrition security and, hence, for nutrition education programmes to have a positive impact, facilitational strategies must be incorporated.

Assessments of nutritional status of semi-arid population in Kiambu District comprising 1042 persons from 260 households showed that 64.2% of the households had at least one malnourished person. The main aim of the study was to establish whether patterns of households malnutrition were distinguishable by specific risk indicators. Fourteen patterns of household malnutrition were established by classifying malnourished people according to age vis-a-vis nutritional status of other members of that household and six risk indicators were found to be related to malnutrition at the household level. Although partial relation was found between patterns and some indicators, no risk was found to be exclusively related to a specific pattern but failure to establish such a relationship was attributed to sample size.