Determinants of health and nutritional status of rural Nigerian women.

This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p < 0.05) better health status, health and nutrition knowledge, food habits, nutrient intake, and self-concept, and adhered less to detrimental cultural practices. However, none of the women met their iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p < 0.05) positive correlation with all nutritional variables, except vitamin C, age-at-marriage (r = 0.719), and nutrition knowledge (r = 0.601). Age-at-marriage had a positive correlation with body mass index (BMI) and all nutritional variables but was significant (p < 0.05) for protein (r = 0.362), calcium (r = 0.358), iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent on the availability of food in the household. Food taboos had no effect on their nutrient intake, since only 5-11% of women adhered to taboos. Although most women gave their children and husbands preference in food distribution, not much difference was found in the amount of food consumed by these women. The ratio of wife's portion to husband's was 1:1.4 for the farmers, 1:1.3 for the traders, and 1:1.2 for the teachers. FGDs revealed that sex discrimination in education prevailed where resources were limited. The results of the study suggest that the basic determinants of health and nutritional status of women are socioeconomic and cultural, education having a mediating or modifying influence on cultural practices.

Perceived causes and management of diarrhoea in young children by market women in Enugu State, Nigeria.

The aim of the study was to determine the perceptions of mothers regarding the causes and management of diarrhoea of their children aged 0-24 months. In Enugu State, Nigeria, 80 market women whose children had diarrhoea during last 6 months were interviewed fortnightly. When possible, the children were observed to determine the types of diarrhoea and treatments given. Fifty-three of the women brought their children to market, and 27 left their children at home. Seventy-one percent of the mothers perceived that diarrhoea was caused by teething. The most common types of diarrhoea occurring in these children were watery diarrhoea (59%) and the so-called teething diarrhoea (29%). Dysentery (6%) and jedi jedi or frothy and mucoid stools (4%) occurred less frequently. In 68% of the cases, drugs were used alone or in conjunction with salt-sugar solution (SSS) or other forms of treatment. These drugs were prescribed by medical personnel (40%), patent medicine dealers (23%), or mothers themselves (30%). About 26% and 39% of the mothers treated, respectively, watery and teething diarrhoeas with drugs only, while 23% used SSS alone. The drugs used were mainly antimicrobials (34%) and a combination of antimicrobial, antimalarial, antacid, analgesic, and some local herbal preparations (21%). The results of the study showed the evidence of unnecessary use of drugs and ignorance about their potential adverse effects. These underscore the need for appropriate primary care education among the market women in Nigeria.

Bacteriological quality of weaning food and drinking water given to children of market women in Nigeria: implications for control of diarrhoea.

Bacteriological quality of weaning food and drinking water given to 2 groups of children aged < or = years was evaluated by estimating bacterial cell count. One group consisted of those taken to market and the other of those left at home in the care of older siblings or house-helps. Bacterial counts (geometric mean) ranged from 5.02 +/- 1.82 to 8.70 +/- 1.0 log10 cfu per g or mL of food, and from 1.15 +/- 1.67 to 6.53 +/- 0.81 log10 cfu per g or 100 mL of water. Analysis of variance showed no significant difference in counts between types of food and between meals (breakfast and lunch). Bacterial contamination increased significantly with storage time, and was, in all circumstances except the water samples, significantly higher in foods given to children left at home. Reheated leftover foods also had significantly higher bacterial load than the freshly-cooked food. Coliform count varied significantly with source of drinking water. Poor hygiene standard (inferred from bacterial contamination) was generally observed among mothers weaning < or = 2-year-old children, while they were engaged in trading activities in the market, thus exposing their children to high risk of diarrhoea. Hygiene was significantly poorer in weaning of children left at home in the care of older siblings or house-helps. This implies that, in spite of their trading activities in the market, mothers still take better care of their babies than the older siblings or house-helps who may be inexperienced. These mothers may need education on childcare and food hygiene to suit to their trading activities, for example, during their monthly meetings. There is also a need to establish ORT (oral rehydration therapy) corners in the markets as part of the municipal services. This can be used not only for efficient and quick management of diarrhoea in the market but also for reinforcing hygiene education.

The effect of two child-care practices of market women on diarrhoea prevalence, feeding patterns and nutritional status of children aged 0-24 months.

A cross-sectional comparative study was conducted in seven markets in Enugu and Nsukka, Nigeria, to evaluate the child-care practices, occurrence of diarrhoea, feeding patterns and nutritional status among 506 and 157 children aged 0-24 months taken to the market (CTTM) by their mothers and those left at home (CLAH) respectively. A lack of a caretaker at home was the most common reason for taking children to the market. The majority (92%) of the caretakers at home were young (< 20 years). There was no difference in the occurrence of diarrhoea in the last month between the CTTM (39%) and the CLAH (41%) groups (p > 0.05). However, there were differences in reported diarrhoea episodes between children aged 0-6 months and higher age classes (chi 2 = 20.0; p = 0.003). Very few children (0.8%) were exclusively breastfed. More CTTM (58%) were still being breastfed than the 42% of CLAH (OR = 1.87; 95% C.I. = 1.27-2.37; p < 0.001). Children cared for at home had a slightly better but nonsignificant (p > 0.05) anthropometric status as characterised by weight-for-age and height-for-age. There was no relationship between feeding patterns and diarrhoea.

PIP: A cross-sectional comparative study was conducted in 7 markets in Enugu and Nsukka, Nigeria, to evaluate child care practices, the occurrence of diarrhea, feeding patterns, and nutritional status among 506 children aged 0-24 months taken to the market (CTTM) by their mothers and 157 similarly aged children left at home (CLAH). 49% of CTTM were infants, compared to only 35% of CLAH. Lack of a caretaker at home was the most common reason why mothers took their children to the market. 92% of caretakers at home were under 20 years old. 39% and 41% of children in the CTTM and CLAH groups, respectively, had diarrhea during the previous month. Differences were reported in the number of diarrhea episodes between children aged 0-6 months and older children. 0.8% of children were exclusively breast-fed, with 58% and 42% of children in the CTTM and CLAH groups, respectively, still being breast-fed. Children cared for at home had a slightly better but nonsignificant anthropometric status as characterized by weight-for-age and height-for-age. No relationship was observed between feeding patterns and diarrhea.

Effect of domestic processing on the cooking time, nutrients, antinutrients and in vitro protein digestibility of the African yambean (Sphenostylis stenocarpa).

The effects of processing (soaking, dehulling, fermentation and heat treatment) on the cooking time, protein, mineral, tannin, phytate and in vitro protein digestibility (IVPD) of the African yambean (AYB) were examined. The cooking time ranged from 90-155 minutes. Soaking reduced cooking time by about 50 percent. Soaking for 12 hours was the most appropriate to reduce cooking time, tannin and phytate levels. It improved in vitro protein digestibility (IVPD). Prolonged soaking (24 hours) decreased calcium (Ca) and iron (Fe) values by 19 percent and 35 percent, respectively. Dehulling showed that Ca, Fe, magnesium (Mg) and zinc (Zn) were concentrated in the seed coat of the AYB. The seeds soaked and dehulled retained Mg and Zn. Dehulling reduced tannin but had no significant effect on phytate and the IVPD of the AYB except for seeds soaked for 12 hours before dehulling. Soaking for 24 hours before dehulling significantly increased crude protein content by 16 percent (p < 0.05). Blanching and roasting increased the IVPD by 8-11 percent. Fermentation had no effect on the crude protein, Ca, Fe, Mg and Zn but significantly reduced phytate content of the AYB. Fermentation had no advantage over heat treatment with respect to improving the in vitro protein digestibility of the AYB.

Protein quality of some Nigerian traditional diets based on the African yambean (Sphenostylis stenocarpa) and pigeon pea (Cajanus cajan).

The protein quality of Nigerian traditional diets based on the African yambean (AYB) and pigeon pea (PP) were performed by in vivo and in vitro bioassays. The individual foods were processed, cooked, dried and mixed to resemble the traditional diets. Weanling male Wistar rats (45-55 g) were used for the bioassay. The rats were fed ad libitum for 35 days of which 28 days were for growth and 7 days for N-balance. All the eleven diets including casein (control) provided 1.6 g N/100 g diet. The parameters tested include PER, growth, N-balance, BV, NPU and apparent digestibility (AD). The rats fed the AYB diets, except AYB: Agidi (Ag), showed superiority in most of the parameters tested. There were significant positive correlations between PER and NPU (r = 0.925; p < 0.001); PER and AD (r = 0.908; p < 0.001); PER and body weight gain (r = 0.969; p < 0.001). The in vitro protein digestibility of the diets was significantly correlated (r = 0.80; p < 0.01) with the in vivo apparent digestibility. These parameters were used to rank the various diets. Crayfish protein was a better supplement to legume/cereal or legume starchy staple mixtures than leguminous oil seed. However, supplementation of PP: steamed corn (SC) diet with crayfish did not prove beneficial. The result showed that diets based on the African yambean, an under-exploited legume, are nutritious. The need for its reintroduction into the fare of the populace through increased production and appropriate processing technology is stressed. The results of this study can form a base for the standardization of Nigerian diets based on these legumes.

Content of antinutrients and in vitro protein digestibility of the African yambean, pigeon and cowpea.

The protein, trypsin inhibitor (TI), tannin, phytate, phytic acid phosphorus and in vitro protein digestibility (IVPD) of cultivars of the African yambean (Sphenostylis stenocarpa) - AYB, pigeon pea (Cajanus cajan) - PP and cowpea (Vigna unguiculata) - CP were determined. The protein content of CP (24-28.0%) was higher than those of PP (21-22.5%) and AYB (21-22.5%). The cream and speckled AYB contained more TI (30.9 and 25.3 mg/g) than PP (7.5-14.1 mg/g) and CP (9.8-20.5 mg/g). Apart from the white CP cultivar, they contained more tannin (1.24-1.42 mg/g) than PP (0.14-0.97 mg/g) and AYB (0.71-1.17 mg/g). Phytate was lowest in the AYB (6.30-7.49 mg/g) than PP (8.31-11.31 mg/g) and CP (8.40-9.92 mg/g). Phytic acid contributed 67-74% of the phosphorous in the AYB, 66-75% in PP and 54-59% in CP. The IVPD of the AYB (73.3 + or - 0.7%) was significantly lower (p <0.05) than those of PP (76.34 + or - 0.2%) and CP (77.8 + or - 0.4%). There was a significant negative correlation between TI and IVPD (r = -0.63, p<0.05). There was no significant correlation between IVPD and phytate and tannin contents. There was a positive correlation between protein content and IVPD (r = 0.69**) for the legumes under study. These legumes may pose no serious problems to populations consuming them especially when heat treatment is applied before consumption.