Status of food safety knowledge, attitude, and practices of caregivers of children in northern Uganda.

The safety of homemade weaning foods in low- and middle-income countries is of great concern as rural households have limited access to standardized commercial weaning foods. In the Acholi subregion of Uganda, complementary foods are locally produced. However, there is limited information on the Food safety knowledge (FSK), food safety attitude (FSA), and food hygiene practices (FHP) of the caregivers. This study examined food safety knowledge, attitude, and practices of the caregivers of children 6-23 months of age in Amuru and Nwoya districts, Northern Uganda, between March 2019 and June 2019. A cross-sectional study was conducted involving 180 caregivers. Data were collected using semi-structured questionnaires and focus group discussions and analyzed using descriptive statistics, multivariate binary logistic regression, and thematic content analysis. Caregivers had sufficient FSK (74.1%) and positive FSA (68.1%). However, only 17.6% of them adhered to FHP. Frequency of food safety training (p = .041) and households with children who suffered from foodborne illness (p = .001) significantly predicted FSK. Conversely, both FSK and FSA were significantly predicted by gender roles in decision-making on household income (p = .006) and households with older children (p = .041). A significant positive correlation was observed between FSK and FSA (r = .406, p = .000). However, major barriers to adherence to FHP were inadequate sanitation facilities and caregiver's workload. The overall nontranslation of sufficient FSK and positive FSA into proper FHP calls for future intervention to harness the sociodemographic factors that influence FSK and FSA and address the barriers to FHP among caregivers.

Prevalence of aflatoxin along processing points of locally made complementary food formulae in northern Uganda: Safety and children's exposure across seasons.

Aflatoxin contamination along the processing points of locally made complementary food composite needs to be ascertained and minimized to reduce exposure to weaning children. The study established the concentrations of total aflatoxin (TAF) and aflatoxin B1 (AFB1) along the processing points of locally made malted millet sesame soybean composite (MMSSC) across season one (wet) and season two (dry) and determined children's exposure to them. A total of 363 samples were collected in 2019. TAF and AFB1 concentrations were determined quantitatively using an enzyme-linked immunosorbent assay (ELISA). Consequently, exposure of individual children was assessed as Estimated Daily Intake (EDI), (ng kg-1 bw day-1). All the samples along the processing points had detectable concentrations of TAF and AFB1 ranging from 0.578 µg kg-1 to 1.187 µg kg-1 and 0.221 µg kg-1 to 0.649 µg kg-1 respectively. Contamination was highest in raw materials; soybean (Glycine max) > sesame (Sesamum indicum), followed by stored composite, freshly prepared composite, and least in millet (Eleusine coracana). Contamination varied significantly across seasons with the wet season having higher contamination than the dry season at P = 0.05. All samples (100%) were within the European Commission (EC) acceptable maximum tolerable level for TAF and AFB1 (4 µg kg-1 and 2 µg kg-1) respectively for processed foods for general consumption. But were below the EU acceptable maximum tolerable level for TAF and AFB1 (0.4 µg kg-1 and 0.1 µg kg-1) respectively for processed baby foods cereals. However, all were within the United States- Food and Drug Authority (US-FDA) and East African Community (EAC) set maximum acceptable limit of 20 µg kg-1 for TAFs, 10 µg kg-1 and 5 µg kg-1 for TAF and AFB1 respectively. Conversely, exposure to these toxins was much higher than the Provisional Maximum Tolerable Dietary Intake (PMTDI) of 0.4 ng kg-1 bw day-1 to 1.0 ng kg-1 bw day-1. A significant difference in exposure to both toxins was observed with the weight. The age of 5 months was the most exposed. A concerted effort is needed to reduce children's exposure to MMSSC to TAF and AFB1, taking sesame and soybean as priority ingredients and proper storage based on season to control contamination.

Status of household dietary diversity and associated factors among rural and urban households of Northern Uganda.

BACKGROUND: In Northern Uganda, 21 and 52.4% of children under five are underweight and stunted, respectively while 32.9% of pregnant women are anemic. This demographic situation suggests among other issues, a lack of dietary diversity among households. Good nutrition practices that confer dietary quality such as dietary diversity are known to depend on nutrition knowledge and attitude and are shaped by sociodemographic and cultural factors. However, there is a paucity of empirical evidence to support this assertion for the variably malnourished population of Northern Uganda. METHODS: A cross-sectional nutrition survey was conducted among 364 household caregivers (182 from two locations in Northern Uganda; Gulu District (the rural) and Gulu City (the urban), selected through a multistage sampling approach. The aim was to determine the status of dietary diversity and its associated factors between rural and urban households of Northern Uganda. The household dietary diversity questionnaire and the food frequency questionnaire on a 7-day reference period were used to collect data on household dietary diversity whereas multiple choice questions and the five points Likert Scale were used to determine knowledge and attitude toward dietary diversity. Consumption of ≤ 5 food groups were regarded as low in dietary diversity, 6-8 food groups as medium and ≥ 9 as high dietary diversity score using the FAO 12 food groups. An Independent two-sample t-test was used to differentiate the status of dietary diversity between the urban and rural areas. The Pearson Chi-square Test was used to determine the status of knowledge and attitude while Poisson regression was used to predict dietary diversity based on caregivers' nutritional knowledge and attitude and their associated factors. RESULTS: The 7-day dietary recall period revealed that dietary diversity was 22% higher in urban (Gulu City) than in the rural area (Gulu District) with rural and urban households achieving medium (score of 8.76 ± 1.37) and high (score of 9.57 ± 1.44) dietary diversity status, respectively. Diets in both locations were dominated by starchy cereals and tubers while animal-source foods and fruits and vegetables were the least consumed. A higher proportion (51.65%) of urban respondents had good nutrition knowledge toward dietary diversity compared to their rural counterparts (23.08%) and a significantly higher proportion (87.91%) of the former exhibited positive attitude towards dietary diversity than the rural counterparts (72.53%). Application of the Poisson regression shows that nutritional knowledge was a positive predictor of dietary diversity in the rural (ß = 0.114; ρ = 0.000) than in the urban areas (ß = -0.008; ρ = 0.551). Caregivers attitude had no significant effect across locations. In terms of associated factors, marital status is a positive predictor of dietary diversity in the urban (ß = 1.700; ρ = 0.001) than the other location (ß = -2.541; ρ = 0.008). Whereas education level of household caregiver and household food expenditure show negative effects across the two locations, the educational level of the household head is an outlier as it positively predicted dietary diversity in the rural (ß = 0.003; ρ = 0.002) when compared to urban area (ß = -0.002; ρ = -0.011). CONCLUSION: Rural households in Northern Uganda have medium-level dietary diversity with urban households having high dietary diversity. Diets in both locations are dominated by starchy cereals and roots and tubers. The urban-rural food divide can be harmonized through nutrition education and outreach, specifically focusing on the FAO 12 food groups. Attitude toward consumption of fruits and vegetables which are seasonally abundant would improve dietary diversity and nutritional outcomes in the study area.

Dietary intake and socio-economic predictors of inadequate energy and nutrient intake among women of childbearing age in Karamoja sub-region of Uganda.

BACKGROUND: Karamoja sub-region is the most food insecure part of Eastern Africa. The poor status of food security in the sub-region is reflected in the high rate of undernutrition among women of childbearing age (WCBA) and children under 5 years (CUFY). The sub-region is unique in Uganda in terms of cultural diversity, agro-ecology and rainfall pattern and agricultural practices. However, the influence of these unique characteristics on dietary intake of WCBA in the sub-region is less understood. Therefore, this study examined dietary intake and socio-economic predictors of inadequate energy and nutrient intake among WCBA in Karamoja sub-region. METHODS: A longitudinal study design was used involving 755 WCBA in the harvesting season where 635 were followed-up in the planting season. Data were collected using 24-h recall, dietary diversity and socio-economic and demographic questionnaires. RESULTS: Intake of energy and nutrients were generally significantly higher (p < 0.05) during the planting season than in the harvesting season. Irrespective of the district, physiological status and season, household consumption of plant-based foods was far higher than intake of animal-based foods dominated by starchy stables (76-100%), dark green leafy vegetables (70-100%) and legumes, nuts and seeds (22-97%) depending on the district. Majority of the respondents had two meals (breakfast: 65-100%; supper: 90-100%) with up to 45% of WCBA who consumed alcohol across meal times. .Overall on average, 57.7, 66.6, 78.5, 60.3, 67.7 and 93.7% of WCBA did not meet the recommended daily allowance (RDA) for energy, protein, calcium, iron, zinc and folic acid, respectively. Binary logistic regression revealed that inadequate intake of energy and nutrients significantly increased (p < 0.05) with the status of being lactating/breastfeeding and was influenced by age of WCBA, number of women married, education level and occupation of the household head depending on season. CONCLUSIONS: This study demonstrated that dietary intake of WCBA in Karamoja sub-region was inadequate. Age of WCBA, number of women married, education level and occupation of the household head and spouse and being a lactating/breastfeeding mother were the key socio-economic and demographic factors that influenced inadequate intake of energy and nutrients among WCBA.

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.

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.

Non-attitudinal and non-knowledge based factors constrain households from translating good nutritional knowledge and attitude to achieve the WHO recommended minimum intake level for fruits and vegetables in a developing country setting: evidence from Gulu district, Uganda.

BACKGROUND: The high level of incidence of mortality attributed to non-communicable diseases such as cancer, diabetes and hypertension being experienced in developing countries requires concerted effort on investment in strategies that can reduce the risks of development of such diseases. Fruits and vegetables (FV) contain natural bioactive compounds, and if consumed at or above 400 g per day (RDMIL) as recommended by World Health Organization (WHO) is believed to contribute to reduced risk of development of such diseases. The objective of this study was to determine in a developing country set-up, the extent to which rural and urban households conform to RDMIL, the status of nutritional attitude (NA) and knowledge (NK) associated with consumption of FV, and to delineate non-attitudinal and non-knowledge-based factors (NANK) that hinder achievement of RDMIL. METHOD: A cross-sectional survey of 400 randomly selected households and 16 focus group discussions (FGD) were conducted using Gulu district of Uganda as a microcosm for a developing country setting. Level of consumption of FV was assessed using 24-h dietary recall and compared to RDMIL as a fraction (%). The status of NK and NA were determined using sets of closed-ended questions anchored on a three-point Likert scale. Further quantitative statistical analyses were conducted using t-test, chi-square, Pearson's correlation and multiple linear regression. FGD provided data on NANK factors and were analysed using qualitative content analysis procedure. RESULTS: Urban and rural inhabitants met up to 72.0 and 62.4% of the RMDIL, respectively, with absolute intake being higher among urban than rural households by 37.54 g. NK and NA were good but the intensity of NK was higher among urban respondents by 11%. RDMIL was positively correlated with NA while socio-demographic predictors of RDMIL varied with household location. FGD revealed that primary agricultural production constraints, market limitations, postharvest management limitations, health concerns, social discomfort and environmental policy restrictions were the major NANK factors that hindered achievement of the RDMIL. CONCLUSIONS: These results indicate that NANK factors constrain households from translating good NA and NK to achieve the RMDIL.

Traditional vegetable preservation technologies practiced in Acholi subregion of Uganda improves mineral bioavailability but impacts negatively on the contribution of vegetables to household needs for micronutrients.

The impact of traditional African preservation methods on the contribution of vegetables to household micronutrient needs (Recommended Dietary Allowance: RDA) has largely remained unquantified. Using Acholi subregion of Uganda as a case area, this study examined using the predominant vegetables consumed in fresh and preserved forms (cowpeas-Vigna unguicullata, okra/lady fingers-Abelmoschus esculentus, Malakwang-Hibscus cannabinus, and eggplants-Solanum melongena), the effect of major traditional vegetable preservation methods (sun drying, boiling and sun drying, and salting and sun drying) on the contents of micronutrients (vitamin A, iron, zinc, calcium, magnesium, and phosphorus), the levels of antinutritional factors (total polyphenols, oxalate, tannins, and phytate), bioavailability of iron and zinc, and the contribution of vegetables to the cumulative annual household RDA for micronutrients. Laboratory analysis showed that all the preservation methods, except the sun drying method reduced the contents of micronutrients by 20%-82% (p ≤ .05). The contents of antinutritional factors reduced by 1%-80% while in vitro bioavailability of iron and zinc increased by 21%-296% (p ≤ .05). Nutritional computation revealed that except for calcium, the preservation methods combined, reduced the contribution of the vegetables to cumulative annual RDA for other micronutrients by 28%-60%. These results demonstrate that improvements in bioavailability of essential nutrients (iron and zinc) by traditional preservation methods investigated are associated with significant loss of micronutrients which culminates in significant reduction in the contribution of cultivated vegetables to household RDA for micronutrients. Traditional African preservation methods should be optimized for nutrient retention.

In vitro bioavailability-based assessment of the contribution of wild fruits and vegetables to household dietary iron requirements among rural households in a developing country setting: The case of Acholi Subregion of Uganda.

Wild fruits and vegetables (WFV) are believed to contain substantial quantities of micronutrients and are commonly consumed in rural areas of developing countries endowed with natural vegetation. Previous studies that provided evidence on the contribution of WFV to household micronutrient intake in a developing country setting did not consider the effect of antinutritional factors. Therefore, applying the in vitro bioavailability assessment technique and using the Acholi subregion of Uganda a case area, this study examined the contribution of commonly consumed WFV to the pooled annual household dietary requirement for iron. Laboratory analysis showed that the concentration of antinutrients varied with plant species but the pool was dominated by phytate (10.5-150 mg/100 g) and phenolic substances (38.6-41.7 mg GAE/g). In vitro iron bioavailability varied with plant species was quantitatively higher from vegetables than fruits by 27% although total concentration of the micronutrient was higher in fruits than vegetables by 142%. Nutritional computation, taking into account, household composition, and physiological status revealed that consumption of WFV resulted in a median contribution of 1.8% (a minimum of 0.02 and a maximum of 34.7%) to the pooled annual household dietary iron requirements on the basis of bioavailable iron fraction. These results demonstrate that WFV contributes meagerly to household iron needs but may serve other dietary and non-nutrient health purposes.

Community-based nutrition-sensitive approach to address short-term hunger and undernutrition among primary school children in rural areas in a developing country setting: lessons from North and North-Eastern Uganda.

BACKGROUND: Undernutrition in childhood is an important factor that greatly impedes the achievement of full human potential at adulthood. Despite increased enrolment of pupils in primary schools in developing countries, short-term hunger and undernutrition continue to impact negatively on school attendance, retention and education outcomes in economically disadvantaged rural areas. This study examined the feasibility of a community-based participatory action research approach building capacity of rural women food vendors to use local food resources to produce nutritionally enhanced food products for primary school feeding in rural localities in a developing country setting. METHODS: Mixed methods approach incorporating focus group discussions (FGDs) to evaluate parents' and school administrators' perceptions of the community-based approach, participatory experimental improvement of nutritional quality of an energy-based cassava product (gari) involving community women food vendors, and cross-sectional acceptability assessment of improved products among rural primary school children. Qualitative content analysis, one-way analysis of variance and correlation analysis was used to analyse FGD data, compare nutritional profile and consumer sensory profile of different products, and examine associations between sensory attributes and acceptability of the products, respectively. RESULTS: The approach of using local food resources to produce nutritious products targeting school feeding was strongly recognised by parents, school administrators, teachers and small scale rural women food vendors as an adoptable nutrition-sensitive means of addressing short-term hunger among primary school children in rural settings. The action research resulted in a highly accepted nutritionally enhanced product (consisting of cassava, soy and silver fish) exhibiting superior nutritional properties (23.29% protein, 90.5 g/100 g calcium, 4.5 g/100 g zinc, 11.6 g/100 g iron, 40.40 g/100 g phosphorus, 61.57 µg/100 g vitamin A) compared to the original energy-dominated cassava product (2.18% Protein, 55.6 g/100 g calcium, 1.2 g/100 g zinc, 4.4 g/100 g iron, 6.6 g/100 g phosphorus, 11.23 µg/100 g vitamin A) (p < 0.05). Nutritional computation revealed that serving 120 g of the new product would suffice to meet 30% of the recommended dietary allowance for essential nutrients that children should receive from school meals. CONCLUSION: Community-level nutrition-sensitive innovation using local foods resources offers the opportunity for rural women food vendors to contribute to addressing short-term hunger and undernutrition challenges in primary schools in economically-disadvantaged localities in developing countries.

The mix of good nutritional attitude and poor nutritional knowledge is associated with adequate intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of Northern Uganda.

Nutritional knowledge and attitude of a population greatly affect intake of essential micronutrients. Much of the understanding on the impact of nutritional knowledge and attitude on nutrient intake has been derived from studies conducted among affluent societies using commercial food products. However, information on the link between status of nutritional knowledge and attitude on intake of essential nutrients from wild fruits and vegetables among rural communities is largely lacking. This study examined the status of nutritional knowledge and attitude associated with intake of vitamin A and iron from wild fruits and vegetables among rural households in Acholi subregion of northern Uganda. A cross-sectional study design making use of individual household questionnaire and proximate dietary recall of a calendar year consumption period involving 248 randomly selected rural households was applied. Results showed that households had good nutritional attitude but poor nutritional knowledge. Status of knowledge was dependent on nutrition training (p = 0.028; coefficient, ß = 0.710) and age of the respondent (p = 0.044; ß = -0.023), whereas status of attitude was predicted by age of the respondent (p = 0.014; ß = 0.048). Consumption of wild fruits and vegetables contributed adequately to the dietary vitamin A and iron requirements of the households. The results have demonstrated that intake of vitamin A and iron from wild fruits and vegetables among rural households is associated with good nutritional attitude but poor nutritional knowledge. A concerted effort is necessary to improve household nutritional knowledge for better utilization of wild fruits and vegetables.

The status of nutritional knowledge, attitude and practices associated with complementary feeding in a post-conflict development phase setting: The case of Acholi sub-region of Uganda.

Inappropriate complementary feeding is an important challenge to proper child nutrition in post-conflict rural areas in many sub-Saharan African countries. While in protected areas during conflict situation and soon after during recovery, communities normally receive nutrition education as part of capacity building to improve knowledge, attitude, and practices to enable them manage maternal and child nutrition issues during the post-conflict development phase. It is largely unknown whether capacity in nutrition provided is maintained and adequately applied in the post-conflict development situation. Using Acholi sub-region of Uganda, an area that experienced violent armed conflict for 20 years (mid-80s-early 2000), as a case study, we examined the status of nutritional knowledge, attitude, and practices associated with complementary feeding among caregivers of 6- to 23-month-old children in a post-conflict development phase following return to normalcy nearly 10 years post-conflict emergency situation. The results showed that a high proportion of caregivers had good knowledge (88%) and attitude (90.1%) toward complementary feeding. However, only a half (50%) of them practiced correct nutrition behavior. Education status of the household head and sex of the child significantly predicted caregiver knowledge on complementary feeding (p ≤ 0.05). Education status of the household head also predicted caregiver attitude toward complementary feeding (p ≤ 0.05). Poverty, food insecurity, and maternal ill health were the major factors that hindered caregivers from practicing good complementary feeding behavior. These results demonstrate that nutrition education on complementary feeding provided to the community during conflict emergency and recovery situation is largely retained in terms of knowledge and attitude but poorly translated into good child feeding practices due to poverty, food insecurity, and maternal ill health. Maternal health, food security, and poverty reduction should be prioritized if adequate complementary feeding is to be achieved among conflict-affected communities in the post-conflict development phase.

The effect of traditional malting technology practiced by an ethnic community in northern Uganda on in-vitro nutrient bioavailability and consumer sensory preference for locally formulated complementary food formulae.

The occurrence of anti-nutritional constituents in plants is an important factor that negatively affects bioavailability of nutrients and effectiveness of plant-based foods in complementary feeding in rural areas in developing countries. However, proven methods that improve bioavailability of nutrients and tailored for application in processing complementary foods among rural communities are largely lacking. This study examined the efficacy of a traditional malting technology practiced by the Acholi ethnic community of northern Uganda to improve protein digestibility and bioavailability of iron and zinc from millet-sesame-soy composite containing 200, 300, and 550 kcal meant for complementary feeding of children aged 6-8, 9-12, and 13-23 years old, respectively. The technology involves washing and soaking of ingredients for 12 hr; malting ingredients individually for 48 hr with water changed after every 6 hr; and sun-drying malted ingredients for 72 hr. Results showed that the level of anti-nutritional factors significantly reduced (p ≤ 0.05) in all the composite formulae except the content of total phenolics in 200, tannins in 300 and 550 kcal, composite formula, respectively. In vitro protein digestibility significantly improved (p ≤ 0.05) in all the composite formulae except in the 200 kcal formula. Iron bioavailability significantly increased (p ≤ 0.05) in all the composite formulae except in the 550 kcal energy category. Improvement in zinc bioavailability was only observed in the 300 kcal formula. However, there were significant reductions (p ≤ 0.05) in the level of caregiver preferences for sensory properties and overall acceptability of the composites. These results demonstrate that the traditional malting technology has potential to improve nutrient bioavailability in plant-based foods but requires improvement in order to increase its efficacy and mitigate negative effects on sensory appeal.

Stakeholders' Perceptions of Agronomic Iodine Biofortification: A SWOT-AHP Analysis in Northern Uganda.

Agronomic biofortification (i.e., the application of fertilizer to elevate micronutrient concentrations in staple crops) is a recent strategy recommended for controlling Iodine Deficiency Disorders (IDDs). However, its success inevitably depends on stakeholders' appreciation and acceptance of it. By taking Northern Uganda as a case, this study aimed to capture and compare the perceptions of seven key stakeholder groups with respect to agronomic iodine biofortification. Therefore, we employed a SWOT (Strength, Weaknesses, Opportunities & Threats) analysis in combination with an Analytical Hierarchy Process (AHP). Findings show that stakeholders (n = 56) are generally positive about agronomic iodine biofortification in Uganda, as its strengths and opportunities outweighed weaknesses and threats. Cultural acceptance and effectiveness are considered the most important strengths while the high IDD prevalence rate and the availability of iodine deficient soils are key opportunities for further developing agronomic iodine biofortification. Environmental concerns about synthetic fertilizers as well as the time needed to supply iodine were considered crucial weaknesses. The limited use of fertilizer in Uganda was the main threat. While this study provides insight into important issues and priorities for iodine biofortification technology in Uganda, including differences in stakeholder views, the application of the SWOT-AHP method will guide future researchers and health planners conducting stakeholder analysis in similar domains.

Fate of Escherichia coli O157:H7 and Salmonella enterica in the manure-amended soil-plant ecosystem of fresh vegetable crops: a review.

Enterohemorrhagic Escherichia coli (EHEC) and Salmonella enterica have been implicated in several disease outbreaks linked to consumption of fresh vegetables. Both ruminant and non-ruminant animals carry EHEC and S. enterica in their gastrointestinal tracts and can shed the pathogens in the faecal matter both in symptomatic and asymptomatic states. Application of animal waste in soil fertility management and irrigation of crops with contaminated waste water has been recognised as an important route through which EHEC and S. enterica can contaminate fresh vegetables during primary production. The behavior of E. coli O157:H7 and S. enterica in the agricultural environment has been extensively studied in the last decades. Several microbiological detection methods have been applied. This review therefore puts together current knowledge on the behavior of E. coli O157:H7 and S. enterica in the manure-amended soil-plant ecosystem of fresh vegetable crops during cultivation under various environmental conditions. The review focuses on methodological issues involved in undertaking survival studies and makes comparative analysis of experimental results obtained from studies conducted under controlled environmental conditions integrating results obtained from field experiments. Finally, a theoretical discussion on the potential likely impact of climate change on pre-harvest safety of field-cultivated vegetables is highlighted.

Bacteriophage P22 to challenge Salmonella in foods.

In this study we considered the influence of phage addition on the fate of Salmonella enterica serovar Typhimurium in different foods. Phage P22 was applied to the following: liquid eggs, energy drinks, whole and skimmed milk, apple juice, chicken breast and chicken mince all spiked with its host, whose growth was monitored for 24 and 48 h at 4 °C. Appreciable host inactivation, generally in the order of 2 log cycles, was achieved compared to phage-free controls in all food matrices when 10(4) UFC/g host inoculum was used. Furthermore, wild food strains belonging to the serotypes Typhimurium, Enteritidis, Derby Give, Newport, Muenchen and Muenster were assayed towards phage P22. Only isolates of Salmonella Typhimurium as well as Salmonella Derby and Salmonella Enteritidis was inhibited by the presence of P22 phage. Additional challenge experiments were carried out by spiking liquid-eggs, chicken breast and chicken mince with mixes of wild Salmonella Typhimurium (at concentration of about 10(4) UFC/g) strains along with their relative phage P22. The results showed a reduction of 2-3 log cycles after 48 h at 4 °C depending on both mix of strains and the specific food. Overall, the results indicate that phages may be useful in the control of food-borne pathogens. The food matrices considered, the liquid more than the solid, do not seem to affect the phage ability of infection compared to similar tests performed in vitro.

Modeling the fate of Escherichia coli O157:H7 and Salmonella enterica in the agricultural environment: current perspective.

The significance of fresh vegetable consumption on human nutrition and health is well recognized. Human infections with Escherichia coli O157:H7 and Salmonella enterica linked to fresh vegetable consumption have become a serious public health problem inflicting a heavy economic burden. The use of contaminated livestock wastes such as manure and manure slurry in crop production is believed to be one of the principal routes of fresh vegetable contamination with E. coli O157:H7 and S. enterica at preharvest stage because both ruminant and nonruminant livestock are known carriers of E. coli O157:H7 and S. enterica in the environment. A number of challenge-testing studies have examined the fate of E. coli O157:H7 and S. enterica in the agricultural environment with the view of designing strategies for controlling vegetable contamination preharvest. In this review, we examined the mathematical modeling approaches that have been used to study the behavior of E. coli O157:H7 and S. enterica in the manure, manure-amended soil, and in manure-amended soil-plant ecosystem during cultivation of fresh vegetable crops. We focused on how the models have been applied to fit survivor curves, predict survival, and assess the risk of vegetable contamination preharvest. The inadequacies of the current modeling approaches are discussed and suggestions for improvements to enhance the applicability of the models as decision tools to control E. coli O157:H7 and S. enterica contamination of fresh vegetables during primary production are presented.

Rhizosphere effect on survival of Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium in manure-amended soil during cabbage (Brassica oleracea) cultivation under tropical field conditions in Sub-Saharan Africa.

The effect of cabbage (Brassica oleracea) rhizosphere on survival of Escherichia coli O157:H7 and Salmonella Typhimurium in manure-amended soils under tropical field conditions was investigated in the Central Agro-Ecological Zone of Uganda. Three-week old cabbage seedlings were transplanted and cultivated for 120 days on manure-amended soil inoculated with 4 or 7 log CFU/g non-virulent E. coli O157:H7 and S. Typhimurium. Cabbage rhizosphere did not affect survival of the 4log CFU/g inocula in manure-amended soil and the two enteric bacteria were not detected on/in cabbage leaves at harvest. The 7 log CFU/g E. coli O157:H7 and S. Typhimurium survived in bulk soil for a maximum of 80 and 96 days, respectively, but the organisms remained culturable in cabbage rhizosphere up to the time of harvest. At 7 log CFU/g inoculum, E. coli O157:H7 and S. Typhimurium contamination on cabbage leaves occurred throughout the cultivation period. Leaf surface sterilisation with 1% AgNO(3) indicated that the organisms were present superficially and in protected locations on the leaves. These results demonstrate that under tropical field conditions, cabbage rhizosphere enhances the persistence of E. coli O157:H7 and S. Typhimurium in manure-amended soil at high inoculum density and is associated with long-term contamination of the leaves.

The effect of micro-architectural structure of cabbage substratum and or background bacterial flora on the growth of Listeria monocytogenes.

The effect of micro-architectural structure of cabbage (Brassica oleracea var. capitata L.) substratum and or background bacterial flora on the growth of Listeria monocytogenes as a function of incubation temperature was investigated. A cocktail mixture of Pseudomonas fluorescens, Pantoea agglomerans and Lactobacillus plantarum was constituted to a population density of approximately 5 log CFU/ml in order to pseudo-simulate background bacterial flora of fresh-cut cabbage. This mixture was co-inoculated with L. monocytogenes (approximately 3 log CFU/ml) on fresh-cut cabbage or in autoclaved cabbage juice followed by incubation at different temperatures (4-30 degrees C). Data on growth of L. monocytogenes were fitted to the primary growth model of Baranyi in order to generate the growth kinetic parameters of the pathogen. During storage, microbial ecology was dominated by P. fluorescens and L. plantarum at refrigeration and abuse temperature, respectively. At all temperatures investigated, lag duration (lambda, h), maximum specific growth rate (micro(max), h(-1)) and maximum population density (MPD, log CFU/ml) of L. monocytogenes were only affected by medium micro-architectural structure, except at 4 degrees C where it had no effect on the micro(max) of the pathogen. Comparison of observed values of micro(max) with those obtained from the Pathogen Modelling Program (PMP), showed that PMP overestimated the growth rate of L. monocytogenes on fresh-cut cabbage and in cabbage juice, respectively. Temperature dependency of micro(max) of L. monocytogenes, according to the models of Ratkowsky and Arrhenius, showed linearity for temperature range of 4-15 degrees C, discontinuities and linearity again for temperature range of 20-30 degrees C. The results of this experiment have shown that the constituted background bacterial flora had no effect on the growth of L. monocytogenes and that micro-architectural structure of the vegetable was the primary factor that limited the applicability of PMP model for predicting the growth of L. monocytogenes on fresh-cut cabbage. A major limitation of this study however is that nutrient profile of the autoclaved cabbage juice may be different from that of the raw juice thus compromising realistic comparison of the behaviour of L. monocytogenes as affected by micro-architectural structure.

The efficacy of electrolysed oxidising water for inactivating spoilage microorganisms in process water and on minimally processed vegetables.

The efficacy of Electrolysed Oxidising Water (EOW) for inactivating spoilage microorganisms in process water and on minimally processed vegetables was investigated. The direct effect of EOW on three important spoilage bacteria namely; Pseudomonas fluorescens, Pantoea agglomerans or Rahnella aquatilis was determined by inoculating tap water or "artificial process water" with approximately 8 log CFU/ml pure culture and electrolysing the resultant solutions. The three bacteria were each reduced to undetectable levels at low (0.5 A) and relatively higher levels (1.0 A) of current in tap water and "artificial process water", respectively. The residual effect of EOW on P. fluorescens, P. agglomerans or R. aquatilis was determined by incubating at room temperature 1 ml (approximately 9 log CFU/ml) pure culture suspensions in 9 ml of EOW-T (EOW produced from tap water), EOW-A (EOW produced from "artificial process water" supplemented with approximately 60.7 mg Cl(-)/l and 39.3 mg Na(+)/l) or deionised water (control) for 0, 15, 45 or 90 min. The bactericidal activity of both EOW-T and EOW-A increased with the concentration of free oxidants and incubation period and the three bacteria were completely reduced at free oxidants-incubation period combinations of 3.88 mg/l-45 min and 5.1 mg/l-90 min in EOW-T and EOW-A, respectively. Two types of industrial vegetable process water; salad-mix and soup process water, which had each a total psychrotrophic count of approximately 8 log CFU/ml were then electrolysed. Without any NaCl addition, only 1.2 and 2.1 log reductions of the psychrotrophs in soup and salad-mix process water was attained respectively. Supplementation of the process water with approximately 60.7 mg Cl(-)/l and 39.3 mg Na(+)/l afterwards resulted in complete reduction of the psychrotrophic count in both process waters, but soup process water required relatively higher levels of current compared to salad-mix water. Finally, fresh-cut lettuce was washed in EOW-T containing 3.62 mg free oxidants/l, EOW-IP (EOW produced from industrial process water) containing 2.8 mg free oxidants/l or tap water (control) for 1 or 5 min. Washing the vegetables for 1 min in EOW-T resulted in 1.9, 1.2, and 1.3 log reductions of psychrotrophs, lactic acid bacteria and Enterobacteriacae, respectively, which increased to 3.3, 2.6, and 1.9 log reductions after washing for 5 min instead. EOW-IP tested in this work had no bactericidal effect on the microflora of fresh-cut lettuce. Electrolysis could therefore be used to decontaminate process water for vegetable pre-washing and to sanitise tap water for final rinsing of vegetables, respectively.