RESUMEN
INTRODUCTION: Childhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Tanzania. METHODOLOGY: A retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child. RESULTS: Majority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0-1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3-6.3; and ARR 2.6, 95% CI 1.3-5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3-3.6; ARR 1.9, 95%CI 1.5-2.5 and ARR 1.9, 95%CI 1.5-2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01-1.6). CONCLUSION: There were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.
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Conducta Alimentaria/psicología , Cuidado del Lactante/métodos , Alimentos Infantiles/análisis , Fenómenos Fisiológicos Nutricionales del Lactante/fisiología , Desnutrición/fisiopatología , Madres/educación , Estado Nutricional , Preescolar , Femenino , Humanos , Lactante , Masculino , Madres/psicología , Estudios Retrospectivos , Tanzanía , Delgadez/fisiopatologíaRESUMEN
BACKGROUND: Malaria control measures were initiated from in October 2005 to August 2006 in the Lower Moshi irrigation schemes, Tanzania. This manuscript reports on the entomological evaluation of the impact of pyrethroid-treated cattle in reducing the population of the Anopheles arabiensis for selected houses in the Lower Moshi irrigation scheme. METHODS: Cattle were sprayed with the pyrethroid (deltamethrin) acaricide. Grazing and non-grazing cattles were compared and assessed for difference in knockdown resistance (kdr) time using cone or contact bioassay and residual effect (mortality). In experimental huts, mortality was compared between the huts with treated and untreated cattle. RESULTS: Results from contact bioassays of cattle treated with deltamethrin showed a knockdown effect of 50% within 21 days for grazing cattle and 29 days for non-grazing cattle. Residual effect at 50% was achieved within 17 days for grazing cattle compared to 24 days for inshed cattle. In discussing the results, reference has been made to the exophilic and zoophilic tendencies of An. arabiensis, which are conducive for zooprophylaxis. Experimental studies in Verandah huts at Mabogini compared An. arabiensis and Culex spp collected from huts with different baits, i e. human, untreated cow and treated cow. Results indicate higher mortality rates in mosquitoes collected from the hut containing the treated cow (mean = 2) compared to huts with untreated cow (mean = 0.3) and human (mean = 0.8). A significantly higher number of Culex spp. was recorded in huts with treated cows compared to the rest. CONCLUSION: This study has demonstrated the role of cattle treated with pyrethroid in the control of malaria and reduction of vector density. It showed that, in areas with a predominant An. arabiensis population, cattle should be placed close to dwelling houses in order to maximize the effects of zooprophylaxis. Protective effects of cattle can further be enhanced by regular treatment with pyrethroids at least every three weeks. This paper demonstrates that cattle can be considered as Insecticide-Treated Material (ITM) as long as acaricide treatment is conducted regularly.