RESUMEN
BACKGROUND: Uganda ranks among the top 10 countries in the world for newborn and child mortality rates and among the top 34 for burden of stunting. This study was conducted to model the impact of stunting on child mortality in the southwest region of Uganda where the prevalence of stunting and child mortality are of great public health concern. METHODS: The study was conducted in Buhweju district in the southwest region of Uganda. The study was cross-sectional involving use of a structured household questionnaire, focus group discussions and interviews with key informants in order to gather relevant information on infant and young child feeding (IYCF) and coverage of antenatal care (ANC) and vaccination programs. The survey of stunting, vaccination and ANC services covered 221 children aged 6-59 months while the assessment of IYCF practices covered 83 children aged 0-23. The Lives Saved Tool (LiST) was used to estimate the impact of stunting on child mortality and cases of stunting averted. RESULTS: The study findings indicated that only 33% of the mothers had knowledge of optimal IYCF and 39% of the sampled children were exclusively breastfed. The majority of the mothers (57%) breastfed their children for less than 2 years and only 31% of the mothers practiced appropriate introduction of complementary foods at 6 months. Only 17% of the 0-23-month-olds received a good standard of IYCF. Only 37% of the mothers reportedly attended ANC 4 times or more during pregnancy and among children aged 6-59 months, only 28% were fully vaccinated. The high impact LiST model estimated that 1297 children under 5 years would be saved and 24,850 cases of stunting averted in the study district. CONCLUSIONS: The study concludes that IYCF practices and coverage of expanded programme on immunization (EPI) and ANC in the study population are sub-optimal thus the high prevalence of stunting and child mortality in the region. LiST demonstrated that prevention of stunting would reduce child mortality in rural Uganda. Therefore, increased investment in cost-effective child survival interventions targeting rural areas of Uganda would have a significant impact on stunting and child mortality.
RESUMEN
BACKGROUND: Stunting affects close to 2.4 million children in Uganda, and it is among the major contributors to the annual loss in productivity of the equivalent of US$899 million. OBJECTIVE: This study sought to identify the key underlying causes of the persistently high stunting rates in a region of Uganda known to have low poverty rates and a high agricultural output. METHODS: A matched case-control study was conducted in Buhweju district, southwest Uganda to compare prior exposures between stunted children (cases) and nonstunted children (controls). RESULTS: The sample comprised 56 cases and 112 controls, totaling 168 children aged 6 to 59 months. There were almost equal numbers of boys and girls in the sample. Boys were significantly more likely to be stunted compared to girls (odds ratio [OR]: 2.2, 95% confidence interval [CI]: 1.1-4.2; P < .05). Stunted children were significantly less likely to be introduced to complementary foods at an appropriate age and their primary caregivers lacked knowledge about stunting. The odds of stunting were 2.4 times greater for children in food-insecure households compared to those in food-secure households (OR: 2.4, 95% CI: 1.1-5.0; P < .05) and 4.5 times greater among children who resided in poor quality houses (OR: 4.5, 95% CI: 1.4-13.0; P < .05). CONCLUSION: Low access to appropriate complementary diets, sex of child, food insecurity, poor socioeconomic status, and low knowledge about stunting were the main predictors of childhood stunting in the study population.
Asunto(s)
Composición Familiar , Abastecimiento de Alimentos , Trastornos del Crecimiento/epidemiología , Adulto , Estudios de Casos y Controles , Preescolar , Femenino , Trastornos del Crecimiento/etiología , Trastornos del Crecimiento/prevención & control , Humanos , Lactante , Masculino , Estado Nutricional , Pobreza , Factores de Riesgo , Encuestas y Cuestionarios , Uganda/epidemiologíaRESUMEN
HIV and AIDS have posed various medical, nutritional, social and economic problems, female-headed households being the most affected. Poor nutritional knowledge and dietary practices common among the most affected households significantly contribute to the rapid progression of HIV. However, very little data exist concerning these aspects of nutrition among women living with HIV and AIDS in resource-limited settings, such as Uganda. The aim of the study was to investigate the gaps in nutritional knowledge, attitudes, and practices and their relationship with sociodemographic characteristics in an urban population of women living with HIV and AIDS in Uganda. In total, 133 women living with HIV were interviewed using a pretested questionnaire. Most (89.5%) women reported being trained on the importance of nutrition for people living with HIV and AIDS (PLWHA) and believed that it is very important to consume a balanced diet (99.5%). On the contrary, only 21.8% consumed at least three meals per day and 39.8% at least six food-groups. They also reported higher dependency on starchy staples while foods of animal origin and fruits that play vital immunity and protective roles were inadequately consumed. Results of bivariate analysis indicated that consumption of a diversified diet was significantly associated with access to food-aid (p=0.006), possibly because access to food-aid reportedly enhances the ability of the household to access other food items. However, much is still needed to understand the drug-food interaction and dietary diversification and enhance proper dietary practices through sustainable projects that ensure increased access to food. Support groups of the PLWHA are a good vehicle for communication of nutrition information and implementation of nutrition-related projects.
Asunto(s)
Conducta Alimentaria , Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Fenómenos Fisiológicos de la Nutrición , Adulto , Estudios Transversales , Cultura , Dieta/métodos , Dieta/psicología , Dieta/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Humanos , Factores Socioeconómicos , Encuestas y Cuestionarios , Uganda/epidemiología , Población Urbana/estadística & datos numéricos , Poblaciones Vulnerables/psicología , Poblaciones Vulnerables/estadística & datos numéricos , Salud de la MujerRESUMEN
Because HIV/AIDS negatively impacts on the food security status of households, it is crucial to identify how households respond to these impacts, in order to identify positive food security entry points and design strategies that can effectively alleviate food insecurity among the households of people living with HIV/AIDS (PLWHA). A cross-sectional study was thus undertaken to establish how HIV affected households in an urban Ugandan setting in terms of response to food shortages and the interrelations between the practice of agriculture by PLWHA households within and around town, food security, access to food aid and dietary diversity among these households. Data for this cross-sectional study were collected using quantitative methods from 144 randomly recruited households of PLWHA (aged 15-49 years) residing in Jinja town in Eastern Uganda. The study showed that the HIV/AIDS pandemic has increased the inability of affected households in the study area to put enough food on the table, possibly because of the continued decreased productivity in these households and the high expenditure on medical costs. Various coping mechanisms identified in the households of PLWHA may contribute to poor adherence to antiretroviral regimes and poor quality of life for all household members. However, the practice of agriculture by PLWHA households was one of the positive coping mechanisms to alleviate food insecurity.