Determinants of dietary diversity and its relationship with the nutritional status of pregnant women.

There is little information regarding factors that determine dietary diversity among pregnant women in Ghana. The present study, therefore, sought to assess the independent predictors of dietary diversity and its relationship with nutritional status of pregnant women in the Northern Region of Ghana. The present study was an analytical cross-sectional survey involving 423 pregnant women in different stages of gestation. The 24-h dietary recall method was used to assess minimum dietary diversity for women (MDD-W), and nutritional status was assessed using mid-upper arm circumference (MUAC) measurements. Binary logistic regression was performed to assess the association between maternal dietary diversity and maternal thinness and a P value of <0⋅05 was considered statistically significant. Of the 423 women, 79⋅9 % (95 % CI 76⋅1, 83⋅7) met the MDD-W and the prevalence of undernutrition among the pregnant women was 26⋅0 %. The analysis showed that women of low household wealth index were 48 % less likely (AOR 0⋅52, CI 0⋅31, 0⋅88) of meeting the MDD-W, whereas women from households of poor food insecurity were 88 % less likely (AOR 0⋅12, CI 0⋅05, 0⋅27) of achieving the MDD-W. Women of low household size were three times more likely of meeting the MDD-W (AOR 3⋅07, CI 1⋅13, 8⋅39). MDD-W was not associated with maternal underweight during pregnancy. In conclusion, the results of the present study showed that food insecurity and not low MDD-W, associated with mothers' thinness (underweight) during pregnancy in peri-urban setting of Northern Ghana.

Relationship between agricultural biodiversity and dietary diversity of children aged 6-36 months in rural areas of Northern Ghana.

In this study, we investigated the relationship between agricultural biodiversity and dietary diversity of children and whether factors such as economic access may affect this relationship. This paper is based on data collected in a baseline cross-sectional survey in November 2013.The study population comprising 1200 mother-child pairs was selected using a two-stage cluster sampling. Dietary diversity was defined as the number of food groups consumed 24 h prior to the assessment. The number of crop and livestock species produced on a farm was used as the measure of production diversity. Hierarchical regression analysis was used to identify predictors and test for interactions. Whereas the average production diversity score was 4.7 ± 1.6, only 42.4% of households consumed at least four food groups out of seven over the preceding 24-h recall period. Agricultural biodiversity (i.e. variety of animals kept and food groups produced) associated positively with dietary diversity of children aged 6-36 months but the relationship was moderated by household socioeconomic status. The interaction term was also statistically significant [ß = -0.08 (95% CI: -0.05, -0.01, p = 0.001)]. Spearman correlation (rho) analysis showed that agricultural biodiversity was positively associated with individual dietary diversity of the child more among children of low socioeconomic status in rural households compared to children of high socioeconomic status (r = 0.93, p < 0.001 versus r = 0.08, p = 0.007). Socioeconomic status of the household also partially mediated the link between agricultural biodiversity and dietary diversity of a child's diet. The effect of increased agricultural biodiversity on dietary diversity was significantly higher in households of lower socioeconomic status. Therefore, improvement of agricultural biodiversity could be one of the best approaches for ensuring diverse diets especially for households of lower socioeconomic status in rural areas of Northern Ghana.

A comparison of pregnancy outcomes in Ghanaian women with varying dietary diversity: a prospective cohort study protocol.

INTRODUCTION: Poor dietary intake during pregnancy can have negative repercussions on the mother and fetus. This study therefore aims to explore the dietary diversity (DD) of pregnant women and its associations with pregnancy outcomes among women in Northern Ghana. The main outcome variables to be measured are gestational weight gain and birth weight. METHODS AND ANALYSIS: A prospective cohort study design will be used and 600 pregnant women in their first trimester will be systematically recruited at health facilities and followed until delivery. In three follow-up visits after recruitment, information on sociodemographic and general characteristics, physical activity (International Physical Activity Questionnaire (IPAQ) short form, dietary intake (24-hour food recall), anthropometry and pregnancy outcomes will be collected. DD will be measured three times using the minimum DD-women (MDD-W) indicator and the mean of the three values overall will be used to determine low (<5 food groups) and high (≥5 food groups) DD. Data will be analysed using SPSS. Comparisons between groups (categorical data) will be made using the χ2 test for proportions, and t-tests and ANOVA will be performed on continuous variables. Regression analysis will be used to identify independent outcome predictors while controlling for possible confounding factors. The results may help to identify differences in DD between healthy and unhealthy pregnancy outcomes. ETHICS AND DISSEMINATION: The study protocol has been approved by the ethics committee of Tehran University of Medical Sciences and the ethical review committee of the Tamale Teaching Hospital. Written informed consent will be obtained from all subjects. The results will be published in due course.

Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital.

Objective. This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate. Methods. A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period. Results. Of the 348 cases, 33.6% recovered (having MUAC ≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, and p < 0.001). The children aged 24-59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6-11 months (AOR = 5.8, 95% CI = 2.5, 10.6, and p < 0.001). Conclusions. Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.