Browsing by Author "Kejo, Dyness"

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Efficacy of a reduced dose of multiple micronutrient powder supplementation among children aged 6-59 months in arusha district, Tanzania
(NM-AIST, 2019-03) Kejo, Dyness
Iron deficiency anaemia is the most prevalent nutritional problem affecting children underfive years old in the developing countries. The deficiency is a result of inadequate intake and insufficient absorption of iron-rich foods that may be caused by diseases or dietary factors prevalent in rural areas. The most appropriate approach for solving the problem in rural settings is the use of Multiple Micronutrient Powder supplements (MNP). The recommended supplementary dose is one (1) sachet per day. However, in areas where resources are limited, the recommended weekly dose of seven sachets is considered expensive. The aim of this study was to assess the efficacy of a lower weekly dose, say three sachets of a MNP for dietary supplementation of complementary foods in Arusha district. A community-based longitudinal study with the intent to assess this efficacy was adopted for this study. Subjects were randomized into four intervention groups and given a Multiple Micronutrient Powder in different doses for six months. Anthropometric measurement, dietary assessment and haemoglobin levels were collected during the intervention involving 436 children under five years old in Arusha district of Tanzania. At baseline, 84.6% of the children were anaemic. Low birth weight and dietary factors (non-consumption of iron rich foods like meat, vegetable, and fruits) were predictors of anaemia. At the end of the intervention, haemoglobin levels were significantly higher in the groups which received three to five sachets of micronutrient powder per week than in children who received one or two sachets per week. Prevalence of infectious diseases was reduced significantly (p < 0.05) from 65% to 30.5% and anaemia, from 100% to 43.0% in all the groups. Two-thirds of mothers expressed willingness to pay for the micronutrient powder at the selling price of 150 TZS per sachet. However, the willingness to pay was associated with socio-demographic and economic characteristics of the participants. This study provides evidence that three to five sachets of MNP per week is an efficacious treatment for anaemia among children under-five years old in Arusha district. Families in low-income communities should be advised to use at least the lower weekly dose of 3 sachets to achieve the desired outcomes.
Efficacy of a reduced dose of multiple micronutrient powder supplementation among children aged 6-59 months in Arusha district, Tanzania
(NM-AIST, 2019-03) Kejo, Dyness
Iron deficiency anaemia is the most prevalent nutritional problem affecting children underfive years old in the developing countries. The deficiency is a result of inadequate intake and insufficient absorption of iron-rich foods that may be caused by diseases or dietary factors prevalent in rural areas. The most appropriate approach for solving the problem in rural settings is the use of Multiple Micronutrient Powder supplements (MNP). The recommended supplementary dose is one (1) sachet per day. However, in areas where resources are limited, the recommended weekly dose of seven sachets is considered expensive. The aim of this study was to assess the efficacy of a lower weekly dose, say three sachets of a MNP for dietary supplementation of complementary foods in Arusha district. A community-based longitudinal study with the intent to assess this efficacy was adopted for this study. Subjects were randomized into four intervention groups and given a Multiple Micronutrient Powder in different doses for six months. Anthropometric measurement, dietary assessment and haemoglobin levels were collected during the intervention involving 436 children under five years old in Arusha district of Tanzania. At baseline, 84.6% of the children were anaemic. Low birth weight and dietary factors (non-consumption of iron rich foods like meat, vegetable, and fruits) were predictors of anaemia. At the end of the intervention, haemoglobin levels were significantly higher in the groups which received three to five sachets of micronutrient powder per week than in children who received one or two sachets per week. Prevalence of infectious diseases was reduced significantly (p < 0.05) from 65% to 30.5% and anaemia, from 100% to 43.0% in all the groups. Two-thirds of mothers expressed willingness to pay for the micronutrient powder at the selling price of 150 TZS per sachet. However, the willingness to pay was associated with socio-demographic and economic characteristics of the participants. This study provides evidence that three to five sachets of MNP per week is an efficacious treatment for anaemia among children under-five years old in Arusha district. Families in low-income communities should be advised to use at least the lower weekly dose of 3 sachets to achieve the desired outcomes.
Efficacy of Different Doses of Multiple Micronutrient Powder on Haemoglobin Concentration in Children Aged 6–59 Months in Arusha District
(Hindawi Scientiﬁca, 2019-02-03) Kejo, Dyness; Petrucka, Pammla; Martin, Haikael; Mosha, Theobald; Kimanya, Martin
In Tanzania’s Arusha District, anaemia is a signiﬁcant public health problem. Recently, home fortiﬁcation with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be eﬀective. However, it is a challenge for deprived families with low income to aﬀord the daily sachet. aim of this study was to compare the eﬃcacy of diﬀerent administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. Is research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n = 369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either ﬁve sachets (n=60), three sachets (n=80), two sachets (n = 105), or one sachet (n = 124) for six months; 310 children completed the study. Using the Hemo Cue technique, a ﬁnger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin levels. The eﬀect of treatment on haemoglobin was assessed with analysis of covariates with Bonferroni post hoc to test group diﬀerence (p > 0.05) from each other. At the end, haemoglobin levels were signiﬁcantly higher in participants who received three or ﬁve sachets of micronutrient powder per week compared to those who received one or two micronutrient powder sachets per week (p < 0.05). The prevalence of illnesses was reduced from 65% to 30.5% in all groups. This ﬁnding indicates that economically challenged families may opt for three times per week sachet administration rather than a more costly daily administration.
Factors Influencing Willingness to Pay for Multiple Micronutrient Powder (Virutubishi) Supplements for Young Children in Arusha, Tanzania
(Journal of Health & Medical Economics, 2018-11-21) Kejo, Dyness; Martin, Haikel; Mosha, Theobald; Petrucka, Pammla; Kimanya, Martin
Background: Multiple micronutrient powders have shown a positive effect on anaemia prevention in children 6-59 months. For the purposes of uptake and sustainability, we explored ‘‘willingness to pay’’ for these health products at the household level for potential of co-investment in multiple micronutrient powders. Methods: During the intervention (six months), household surveys were conducted once with mothers of children 6-59 months in the Arusha District regarding willingness to pay for the multiple micronutrient powders. Results: Results from the survey show that about 66% of the target mothers are willing to pay for multiple micronutrient powders required for feeding of children at 0.068$ per sachet. Willingness to pay was associated with higher paternal education, higher maternal age, and families which do not keep animals. Conclusion: The results findings help to know the market situation of nutritional products. This information is useful for health policy planners in assessing economic viability and sustainability of the distribution of multiple micronutrient powders to consumers to avert micronutrient deficiencies and their effects on young children.
Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania
(Dove Press Journal, 2018) Kejo, Dyness; Petrucka, Pammla M; Martin, Haikel; Kimanya, Martin E; Mosha, Theobald CE
Anemia is a global health problem affecting most developing countries. We examined the prevalence of anemia and its predictors among children under 5 years of age in Arusha District, Tanzania. Random sampling technique was used to identify 436 children aged 6–59 months. Anemia status was assessed by measuring hemoglobin concentration from blood sample obtained from a finger prick and HemoCue® Hb 201+ photometer. Demographic information and dietary intake data were collected using a standardized questionnaire. Anemia cut-off points were defined according to World Health Organization standards for children aged 6–59 months. Logistic regression using backward procedure was used to estimate odds ratios (ORs) at 95% confidence intervals (CIs). Prevalence rate of anemia among under-fives was found to be 84.6% (n=369). Multivariable logistic regression identified the following predictors of anemia; low birth weight (adjusted OR (AOR): 2.1, 95% CI: 1.1–3.8), not consuming meat (AOR: 6.4, 95% CI: 3.2–12.9), not consuming vegetables (AOR: 2.1, 95% CI: 1.1–4.1), drinking milk (AOR: 2.5, 95% CI: 1.1–5.2), and drinking tea (AOR: 4.5, 95% CI: 1.5–13.7). It was concluded that low birth weight and dietary factors (ie, low or nonconsumption of iron-rich foods like meat, vegetables, and fruits) were predictors of anemia among under-five children living in this rural setting. Community education on exclusive breastfeeding and introduction of complementary foods should be improved. Mothers and caretakers should be educated about nutrition, in general, as well as potential use of micronutrient powder to improve the nutritional quality of complementary foods.
Prevalence and predictors of undernutrition among underfive children in Arusha District, Tanzania
(Wiley Periodicals, Inc., 2018) Kejo, Dyness; Mosha, Theobald; Petrucka, Pammla; Martin, Haikael; Kimanya, Martin
Childhood undernutrition is a global health challenge impacting child growth and survival rates. This deficit in nutritional status contributes to the increasing chronic disease prevalence and economic burden in individuals and throughout developing contexts. A community-based cross-sectional study was conducted in Arusha District of Tanzania to determine the prevalence and predictors of undernutrition in 436 children. A structured questionnaire was used to collect data on demographic and socio- economic factors as well as feeding practices and prevalence of preventable childhood diseases. Anthropometric data were collected through the measurement of length/height and weight of all children. The prevalence of undernutrition was estimated based on Z-scores indices below −2SD of the reference population for weight for age (underweight), height for age (stunting), and weight for height (wasting). Fifty percent, 28%, and 16.5% of the children were stunted, underweight, and wasted, respectively. The age above 2 years and being a male were associated with stunting. The age above 2 years, nonexclusive breastfeeding children, and living at Seliani and Oturumeti were associated with being underweight. Similarly, morbidity, none exclusively breastfed children, living at Oturumeti, and being born to a mother 35 years and above were associated with wasting. In this study, we found the prevalence of child undernutrition in Arusha District is high in comparison with national and regional trends and appears to be associated with being a male. It is recommended that nutritionists and health planners should focus on these key predictors when planning nutrition interventions to address the problem of undernutrition among under-five children in Arusha District.