Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study.

BACKGROUND: Undernutrition accounts for nearly half of under-five child mortality in developing countries where household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture in those countries, limited information exists on whether undernutrition in children under five varies with agro-ecological location. METHODS: Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area, and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral, and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The level of statistical significance was set at p ≤ 0.05. RESULTS: The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001) increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies. CONCLUSION: This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such locations should be agroecology specific.

Determinants of undernutrition among settled pastoralists' children aged 6-59 months in Kenya.

The transition from nomadism to sedentary lifestyle has introduced changes in diets and undernutrition is endemic among settled pastoral households. This study aimed to investigate the underlying factors affecting stunting, underweight, and wasting of children aged 6-59 months in Marsabit County, Kenya. A cross-sectional household survey was conducted in six wards capturing pastoral, agro-pastoral, and urban livelihood practices. Using multistage sampling method, 394 children aged 6-59 months participated with written consent from the caregivers. A pretested questionnaire and anthropometric measures were used during data collection. Population characteristics were summarized into means and proportions, while chi-square and analysis of variance were used to evaluate associations between variables. Backward logistic regressions were used to explore predictors of stunting, underweight, and wasting, respectively. The results showed that the mean Height for Age Z-score, Weight for Age Z-score, and Weight for Height Z-score were -1.51, 1.54, and 1.02, respectively. The prevalence of stunting, underweight, and wasting was 38.1%, 23.0%, and 18.5%, respectively. The age of child, source of drinking water, and waste disposal were some of the main factors influencing stunting among children. In conclusion, the prevalence of undernutrition was high compared to the World Health Organization recommended cutoffs. Water sources hygiene, and caregiver's income were some of the main predictors of undernutrition among children. Development agencies need to focus on the supply of potable water, access to toilet facilities, in addition to nutrition education on hygienic complementary feeding practices among pastoral caregivers.

Preliminary evaluation of probiotic properties and safety profile of Lactiplantibacillus plantarum isolated from spontaneously fermented milk, Amabere amaruranu.

The aim of this study was to assess the probiotic potential and safety profile of a Lactiplantibacillus plantarum EGER41 strain isolated from Kenyan spontaneously fermented milk, Amabere amaruranu. The L. plantarum EGER41 isolate was tested for temperature sensitivity (at 15 °C, 30 °C, 37 °C, and 45 °C), pH tolerance (at 2.0, 2.5, 3.0, 3.5, and 6.5 as control), and 0.4% phenol tolerance to observe its survival in the gastrointestinal tract of humans. For safety evaluation of the isolate, antagonistic activity was tested against pathogenic strains of Staphylococcus aureus, Escherichia coli, Salmonella enterica serovar Typhi, and Candida albicans, while antibiotic susceptibility pattern was examined using nalidixic acid, ampicillin, azithromycin, ciprofloxacin, tetracycline, gentamicin, and chloramphenicol antibiotic discs and haemolytic activity was done using lamb blood agar. The L. plantarum isolate had an optimal growth at 37 °C, it also demonstrated low pH tolerance (2.0-3.5). It was able to maintain its viability (∼100%) after exposure to 0.4% phenol. The selected isolate showed inhibition (antagonistic activity) against the pathogens with S. typhi having the largest (ZDI = 31.0 ± 1.73 mm) zone of diameter inhibition (ZDI) and Candida albicans having the least (ZDI = 18.0 ± 0.76 mm). L. plantarum isolate was sensitive to Azithromycin, tetracycline and chloramphenicol and was intermediately sensitive to gentamycin, while it was resistant to nalidixic acid, ampicillin, and ciprofloxacin. The isolate also exhibited γ-haemolytic activity hence safe for use as a starter culture and was identified as a Lactiplantibacillus plantarum EGER 41 strain based on 16S rRNA gene sequencing. The selected isolate can potentially be used as a starter culture and a probiotic since it had excellent probiotic properties.

Agroecology influences Salmonella food contamination with high exposure risk among children in Karamoja sub-region: A high diarrhoea prevalent locality in Uganda.

Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using polymerase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 ± 0.00 to 8.23 ± 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p < 0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33-90%, 40-67%, and 17-88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE, and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.