Browsing by Author "Mollay, Clara"

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Analysis of nutritional adequacy of local foods for meeting dietary requirements of children aged 6-23 months in rural central Tanzania
(Archives of Public Health, 2017-08-17) Raymond, Jofrey; Agaba, Morris; Kassim, Neema; Jerman W, Rose; Mollay, Clara
Under nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 – 23 months in resource-poor settings. Methods: A cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0. Results: The results showed that the prevalence of stunting, wasting and underweight for children aged 6–23 months was 30–41%, 1.5–3% and 4–9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6–23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices. Conclusions: The study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6–23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing the way local diets are constituted so as to achieve nutrient recommendations for infants and young children.
Childhood dietary exposure of aflatoxins and fumonisins in Tanzania: A review
(Taylor & Francis Online, 2020-12-24) Mollay, Clara; Kassim, Neema; Stoltzfus, Rebecca; Kimanya, Martin
Aflatoxins (AFs) and Fumonisins (FBs) are common contaminants of maize, from secondary metabolites of fungi. Presence of AFs and FBs in maize-based complimentary food is evident in various studies conducted in Tanzania and elsewhere. Consequently, Infant and Young children (IYC) aged between 6 and 24 months in Tanzania who consume monotonous maize-based foods are at a high risk of exposure to these toxins. The AF or FB exposures have been linked to low awareness and inadequate knowledge or limited skills of IYC feeding practices among mothers and caregivers. This review reveals that more researches are needed to identify appropriate feeding practices in Tanzania to improve child growth. Meanwhile, stakeholders should direct efforts on education to subsistence farmers including mothers and caregivers on interventions to minimize mycotoxin contamination of cereal and nut-based complementary foods in the country.
Complementary feeding in Kongwa, Tanzania: Findings to inform a mycotoxin mitigation trial.
(John Wiley & Sons Ltd., 2021-05-04) Mollay, Clara; Kassim, Neema; Stoltzfus, Rebecca; Kimanya, Martin
Complementary feeding of 6- to 24-month-old infants and young children with adequate, safe and developmentally appropriate food is essential to child health. Inappropriate complementary foods and feeding practices are linked to the high incidences of undernutrition among infant and young children in most developing countries, including Tanzania. Mycotoxin risk is an additional concern, given the documented presence of aflatoxin and fumonisin in food systems of Africa, especially maize and groundnut. In preparation for a trial of mycotoxin mitigation, we conducted focus group discussions and recipe trials to explore complementary foods and feeding practices in Kongwa, a rural district of central Tanzania. Sixty mothers of infants from 6 to 18 months of age in five villages across the district were purposefully sampled. During focus group discussions, mothers reported to mostly feed their children with cereal and groundnut-based foods as thin or thick porridges. The most common porridge preparations contained cereal (mostly, maize) ranging from 66.7% to 80.0% by weight and groundnuts from 7.7% to 33.3%. The ratio of cereal to groundnut ranged from 3:1 to 4:1. For the recipe trial sessions, mothers chose similar ingredients reported during discussions to prepare complementary foods. The reliance on maize and groundnuts in complementary foods predisposes the children to undernutrition and exposure to aflatoxins and fumonisins. These formative research results suggest multiple intervention points to improve complementary feeding and reduce mycotoxin exposure in this population, including education messages package on feeding practices, mycotoxin control practices and complementary food formulation.
Complementary feeding practices and the risk of exposure to aflatoxins among infants and young children in Kongwa, Tanzania
(NM-AIST, 2022-08) Mollay, Clara
Aflatoxins (AFs) are secondary fungal metabolites that commonly contaminate foods like nuts and cereals and pose major public health concerns like impaired child growth, immune system suppression, liver cancer and death. In sub-Saharan Africa, infants and young children (IYC) feed on complementary foods (CFs) containing ingredients susceptible to contamination with AFs. Although the presence of AFs in foodstuffs has been reported for over 60 years, very few studies have focused on CFs, yet children are more vulnerable due to relatively small bodyweights and underdeveloped immune systems. This study was conducted in Kongwa District, Tanzania in 2017 and 2018, to estimate the contribution of the main CF ingredients to aflatoxin exposure among IYC. The study documented the common ingredients of CFs and the intake of CFs by 35 (6-12- month-old) IYC using multiple-pass 24-h dietary recalls. The levels of AFs contamination in the collected samples were determined using High-Performance Liquid Chromatography while the exposure of IYC to AFs was estimated by a deterministic approach. The study further tested acceptability of Aflatoxin-safe maize-groundnut pre-blended flour (AFSaBF) and groundnut powder (AFSaGP). The key ingredients of CFs were milled maize, sorghum, pearl-millet, rice, and groundnuts (pre- or post-blended with cereals) prepared as thin/stiff porridge. The average per-capita daily intake of CFs flour was 89.45 g. About 82.14% of the samples had AFB1 levels ranging from 0.27–317 μg/kg, and the exposure levels ranged from 0.33-1168 ng/kg body weight (bw)/day. The Margins of Exposure were < 10 000 for all IYC, signifying a public health concern. The mothers and IYC generally accepted the improved porridge flour and groundnut powder. This is important information for future studies aiming at reducing exposure to AFs in this community. Groundnut and maize flours are the main contributors to the exposure of IYC to AFB1 in Kongwa district. Community education on mycotoxins-mitigation practices like appropriate pre and post harvest handling and complementary feeding practices may minimize aflatoxin exposure among IYC in Kongwa and other communities with similar settings. Appropriate feeding practices may entail diet diversification and substitution of groundnut or maize with other food ingredients that are less-prone to AFs contamination.
Determinants of food intake and nutritional status among inpatients in northern hospitals in Tanzania
(INNSpub, 2024-07) Ijumaa, Asia; Mollay, Clara; Martin, Haikael
Adequate nutrition is a key among hospitalized patients. It is crucial and most significant aspect of improving quality of life of inpatients. However, hospitals in developing nations challenged with adequate meal provisions. In Tanzania, meal provision isn’t part of inpatients service. This impacted quality of life, causing an increased number of days in hospital stay. Furthermore, research has demonstrated the significance of food consumption to promote recovery. Cross-sectional study design was used in this study. Data were analyzed for descriptive statistical inferences by using R statistical software. Results showed; determinants of food intake were; distance to hospital, 76% inpatients used more than 60 minutes to arrive at hospital and 31% stayed hospital for 15 days and above. Moreover, dietary study was conducted; results showed 70% of inpatients didn’t meet minimum dietary diversity. Insufficient nutrition awareness was another determinant where, 70% of inpatients didn’t understand balanced diet. Findings revealed that, 86% of inpatients consumed monotonous diet high in starch, 12% of adult inpatients were underweight (BMI <18.5) while 7% were obese with BMI > 30. Twenty nine percent of children aged 6 to 59 months were severely stunted (SD < -3). In this study, association between dietary intake and distance from home indicated, some patients lacking food services because of leaving far from hospital. It was concluded that, higher proportion of inpatients didn’t meet minimum dietary diversity due to monotonous diet they consumed. To meet SDGs challenges of zero hunger, good health and well-being, hospital meal provision is essential.
Heritability and relationship between drought tolerance traits and yield in groundnuts (arachis hypogaea l.) under different watering regimes
(Asian J Agri Biol,, 2016) Philipo, Mashamba; Mollay, Clara; Nchimbi-Msolla, Susan
Improvement of groundnuts for drought tolerance could increase production in drought prone areas.This study aimed at determining the heritability estimates and relationship of HI and SCMR with yield and yield components using 30 groundnut genotypes planted under different watering regimes, so as to speed up the selection and breeding of groundnut genotypes tolerant to drought. A completely randomized design arranged in a split plot experiment with four replications was conducted in screen house in Morogoro, Tanzania. Data collection was done on plant height, number of pod/plant and pod yield/plant. Drought tolerant traits measured included, harvest index (HI), SCMR at 40, 60 and 80 DAS. Broad-sense heritability was calculated for HI, pod yield, number of pod/plant and SCMR. Results showed that number of pods/plant, SCMR at 60 DAS and HI were significantly related to pod yield in all watering condition. Heritability of the traits ranged from 0.22 to 0.59 with HI having highest value and number of pods lowest in WW while in WS condition heritability was generally lower from 0.04 to 0.45. Due to SCMR at 60 DAS, number of pods/plant and HI having moderate heritability and significant correlation with pod yield under water stress condition, these could be useful criteria in drought tolerance selection.
Household food insecurity and gender inequity is associated with high prevalence of maternal depression amongst female farmers with young children in rural Tanzania
(The Federation of American Societies for Experimental Biology, 2018-10-03) Blacker, Lauren; Santoso, Marianne; Harnett, Laura; Kassim, Neema; Mollay, Clara; Martin, Haikael; Mtinda, Elias; Kalonga, Esther; Mtei, Kelvin; Kalonga, Joseph; Bezner, Rachel; Young, Sera
There is growing recognition of the importance of maternal mental health for the well-being of both mothers and children. In addition to being of importance to public health concern on its own right, maternal depression could impede women's capacity to provide quality care to their children. However, the covariates of maternal depression, especially in low-resource settings, are not well-understood. In particular, the role of gender equity in maternal depression needs further investigation. Therefore, we sought to understand covariates associated with maternal depression in a rural farming community in Tanzania. We hypothesized that greater food insecurity and gender inequity in a household would be positively correlated with maternal depression. The Singida Nutrition and Agroecology Project (SNAP-Tz) is a participatory agroecology and nutrition intervention with rural farmers with children <1 y in Singida, Tanzania. As part of the baseline assessment in February 2016, women from the 587 participating households were asked about a range of socio-demographic, agricultural, health, and nutrition topics. The Center for Epidemiologic Studies Depression Scale (CES-D, range: 0–65) was used to measure maternal depression. The Household Food Insecurity Access Scale (HFIAS, range: 0–27) was used to measure household food insecurity. Gender equity was indicated by a summed score of husband's help with household chores (range: 0–7), women's (dis)satisfaction with leisure time, and women's experience with domestic violence. Social support was measured using the Perceived Social Support scale (PSS, range:0–40). Multivariate linear regression models of depression were then built using backwards stepwise elimination and include village fixed effects. Standard error estimates considered clustering at the village level. CESD scores indicated probable depression (CES-D≥17) among 69.2% of women. Probable major depression (CES-D≥26) was indicated for 42.5% women. The mean HFIAS of 14.0 (sd: 7.9) suggested that food insecurity was also very common. In multivariate models of depression, food insecurity score was positively and strongly correlated with maternal depression score (β=0.62, p=0.000). Having experienced domestic violence was positively associated with increased maternal depression score (β=4.29, p=0.004). Greater help from husband and satisfaction with amount of leisure time were negatively correlated with maternal depression score (β=−0.65, p=0.011 and β=−3.00, p=0.000, respectively). In sum, the prevalence of maternal depression is very high in Singida, Tanzania. While some covariates were not modifiable, several important ones were, including food insecurity, unbalanced household division of task, and domestic violence. Causality should be further explored, but these data suggest important and novel domains in which to intervene to improve maternal mental health.
“I Don’t Have Time to Exercise”: Determinants of Physical Activity and Diet Consumption Among Adolescents Living with HIV in Southern Tanzania – A Phenomenological Qualitative Study
(Taylor & Francis, 2025-05-22) Maganga, Justina; Katende, Andrew; Luoga, Ezekiel; Nshatsi, Nancy; Siru, Jamal; Sigalla, George; Mollay, Clara; Weisser, Maja; Mtenga, Sally
Background: Low physical activity and unhealthy diets are among the key modifiable risk factors for non-communicable diseases (NCDs), often initiated in adolescence. Little is known about the underlying factors influencing these two behaviors, particularly in adolescents living with HIV (ALHIV). This study aimed at qualitatively exploring the factors perceived to influence physical activity and diet consumption in this vulnerable population. Methods: Semi-structured in-depth interviews were conducted with ALHIV aged 15 to 19 years (N=22) and their parents and caregivers (N=10) to explore the lived experiences and perceptions regarding physical activity and diet consumption. The interviews were carried out from May to July 2024 at the Chronic Diseases Clinic in Ifakara (CDCI) in Tanzania. Thematic content analysis was performed aided by NVivo software version 14. Three levels of the socio-ecological model (intrapersonal, interpersonal, and community levels) guided the theoretical categorization of findings. Results: Factors reported to influence physical activity in ALHIV were intrapersonal factors (time constraints, insufficient knowledge); interpersonal (encouragement from family members and peers); and community level aspects (gender and social norms, negative beliefs, inadequate facilities). On the other hand, intrapersonal factors (lack of autonomy, weight gain concerns, food preferences); interpersonal factors (low family income, large family size); and community level factors (increased availability of fast foods) were reported to influence diet consumption among ALHIV. The adolescents’ parents and caregivers similarly shared some of these views. Conclusion: The findings suggest that both physical activity and diet consumption in ALHIV are influenced by multiple factors in the socio-ecological system. The community, parents and caregivers need to be engaged to provide support systems to address barriers to physical activity and diet consumption in ALHIV. Physical activity and nutrition education need to be integrated into HIV care programs and guidelines to emphasize these health behaviors in this population.
Main complementary food ingredients contributing to aflatoxin exposure to infants and young children in Kongwa, Tanzania
(Elsevier Ltd., 2021-11-23) Mollay, Clara; Kimanya, Martin; Kassim, Neema; Stoltzfus, Rebecca
Complementary foods (CFs) provided to infants and young children (IYC) in sub-Saharan Africa contain ingredients that are susceptible to aflatoxin contamination. Chronic dietary exposure to aflatoxins is associated with health consequences. This study assessed the risk of exposure of IYC (6-12-month-old) in Kongwa, Tanzania to aflatoxins through CFs. The intake of aflatoxin susceptible flours (ingredients) in CFs by 35 IYC was estimated through multiple-pass 24-hrdietary recalls. Samples of the ingredients were tested for aflatoxins using High-PerformanceLiquid Chromatography. Exposure of a child to aflatoxins was estimated by a deterministic approach. The contribution of an ingredient to the overall exposure was estimated statistically. The key ingredients of CFs consumed by the IYC were maize, sorghum, pearl millet, rice, and groundnuts (pre-or post-blended with the other ingredients). Cereal and groundnut-based CFs weregiven as thin or stiff porridge. The average per capita daily intake of CFs was 89.45 g. About 82.14% of the CF ingredients were contaminated with aflatoxin B1 (AFB1) in the range of 0.27– 317 μg/kg, with a median of 3.96 μg/kg. AFB1 exposures ranged from 0.33 to 1168 ng/kg bw/day(median of 23.06 ng/kg bw/day). The Margins of Exposure were less than 10,000 for all the IYC, signifying a public health concern. Post-blended groundnut flour, followed by maize, contributed the most to the exposure of IYC to AFB1. Groundnut and maize used as CFs in Kongwa are likelyto be the main contributors to the exposure of IYC to AFB1. Caregivers should be advised to replace maize and groundnuts with well-processed less susceptible cereals like pearl millet and other legumes, respectively.