Browsing by Author "Modern, Grantina"

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Assessment of environmental enteric dysfunction (eed) in Healthy and undernourished children-a crosstalk between eed and stunting
(NM-AIST, 2021-08) Modern, Grantina
Undernutrition affects 20% of children under five in the developing world. Stunting is a prevalent form of undernutrition. Global prevalence of stunting in 2019 was 21.4%, while current Tanzania national average is 34%. Ruvuma is one of the regions with highest prevalence of stunting (44%) in Tanzania. This dissertation involved studies on factors responsible for the high prevalence of stunting in Ruvuma and their association with environmental enteric dysfunction (EED) in children. The study included randomly and conveniently sampled children below 5 years of age between April 2019 – January 2020 who attended outpatient clinics at hospitals in Ruvuma. Among children in the cross-sectional survey, 46% were females and 45.6% were stunted, while the case-control study had 42% females, 78% stunted cases, and EED prevalence of 57%. Through bivariate analysis, stunting was associated with gender (χ2 = 6.6759, df = 1, p = 0.009772), hand washing before food (χ2 = 5.1213, df = 1, p = 0.02363), location of hospital (χ2 = 3.851, df = 1, p = 0.04972) and use of Municipal garbage collection system (χ2 = 3.6814, df = 1, p = 0.05502). Moreover, diarrhea was associated with toilet sharing (χ2 = 5.4703, df = 1, p = 0.002), use of household’s toilet (χ2 = 4.0224, df = 1, p = 0.004) and rinsing child feces into toilet (χ2 = 3.6814, df = 1, p < 0.01). Multivariate logistic regression analyses showed that, stunting risk increased with male gender (OR (95%CI) = 1.7945 (1.1944 –2.712), age (OR (95%CI) = 1.3122 (1.1484 –1.507), and decreased with hand washing before meal (OR (95%CI) = 0.5403 (0.3042 –0.940). Finally, diarrhea risk increased with toilet sharing (OR (95%CI) = 2.154 (1.153 –3.953) and decreased with child’s use of toilet (OR (95%CI) = 0.510 (0.259 –0.945). Our study generally revealed important factors that determined observed high prevalence of stunting in Ruvuma. These factors can be modified through health interventions to reduce the observed high prevalence. Nevertheless, the association between EED and stunting is undeniable and needs further assessment in a bigger study.
Causal relationship between Environmental Enteric Dysfunction (EED), poor WaSH practices and growth failure in children from Rukwa-Tanzania
(Elsevier, 2022-07) Modern, Grantina; Mpolya, Emmanuel; Sauli, Elingarami
Stunting is the most prevalent form of chronic undernutrition. The Rukwa region in Tanzania has one of the highest prevalence of stunting, despite being one of the most food secure region in the country. It is therefore important to understand other possible environmental and biological factors for stunting/growth failure, apart from food insecurity. This was a hospital based prospective cohort study aimed at assessing other causal relationship between Environmental Enteric Dysfunction (EED), WaSH practices and growth failure in children aged between 1–2 years from Rukwa, Tanzania, using univariate and multivariate logistic regression models. We found very significant causal relationship between growth failure and combined water availability (p = 0.0055), toilet sharing by parents/caregivers (OR = 2.632, CI: 1.156–6.233, p = 0.023 from univariate analysis, and OR = 4.067, CI: 1.484–12.206, p = 0.008 from multivariate analysis), and handwashing by parents/caregivers before food (OR = 3.363, CI: 0.928 -11.454, p = 0.05 from univariate analysis and OR = 15.038, CI:2.422–115.8, p = 0.005 from multivariate analysis). This significant causal relationship may be linked to increased diarrheal incidence and other waterborne infections among the studied children, which may then lead to inadequate absorption of nutrients and subsequent growth failure. The findings herein should therefore improve policy and programs designed to deliver targeted intervention strategies in Tanzania, to also identify and include other entry points for managing child growth failure and improving WaSH services.
Correlates of diarrhea and stunting among under-five children in Ruvuma, Tanzania; a hospital-based cross-sectional study
(Elsevier, 2020-07) Modern, Grantina; Sauli, Elingarami; Mpolya, Emmanuel
Undernutrition affects 20% of children under five in the developing world. Stunting is a form of undernutrition when children have low height for their age. Global prevalence of stunting in 2019 was 21.4%, while current Tanzania national average is 34%. Ruvuma region has one of highest prevalence of stunting (44%) in Tanzania, which prompted this cross-sectional study on correlates responsible for this high prevalence. The study included randomly sampled children below 5 years of age who attended outpatient clinics at hospitals from Ruvuma between April – May 2019. The mean and median ages of children were 18 and 13 respectively. Among children, 46% were females and 45.6% were stunted. More male children (52%) were stunted than females. Through bivariate analysis, stunting was associated with gender (χ2 = 6.6759, df = 1, p = 0.009772), handwashing before food (χ2 = 5.1213, df = 1, p = 0.02363), location of hospital (χ2 = 3.851, df = 1, p = 0.04972) and use of Municipal garbage collection system (χ2 = 3.6814, df = 1, p = 0.05502). Moreover, diarrhea was associated with toilet sharing (χ2 = 5.4703, df = 1, p = 0.002), use of household's toilet (χ2 = 4.0224, df = 1, p = 0.004) and rinsing child feces into toilet (χ2 = 3.6814, df = 1, p < 0.01). Multivariate logistic regression analyses showed that stunting risk increased with male gender (OR (95%CI) = 1.7945 (1.1944 – 2.712), age (OR (95%CI) = 1.3122 (1.1484 – 1.507), and decreased with handwashing before meal (OR (95%CI) = 0.5403 (0.3042 – 0.940). Finally, diarrhea risk increased with toilet sharing (OR (95%CI) = 2.154 (1.153 – 3.953) and decreased with child's use of toilet (OR (95%CI) = 0.510 (0.259 – 0.945). Our study revealed important correlates that determined observed high prevalence of stunting in Ruvuma. These correlates can be modified through health interventions to reduce this high prevalence.