Doctoral Degrees (Nutrition and Dietetics)
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Browsing Doctoral Degrees (Nutrition and Dietetics) by Subject "24 hour recall"
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Item Open Access Food safety indicators in household food security in the Ruralvhembe district, Limpopo province, South Africa(University of the Free State, 2014-07) Nesamvuni, C. N.; Dannhauser, A.; Viljoen, B. C.; Joubert, G.English: Available literature emphasises the importance of food safety in obtaining coordinated and conceptually informed results of food security, with the view to improve intervention programmes to achieve progress in obtaining food security in households. The study was undertaken intending to investigate possible food safety indicators that might possibly contribute towards improved assessment of household food security (HFS) in the rural Vhembe District, Limpopo Province, South Africa. The objectives were to determine HFS and household food safety, as well as the relationship between HFS and food safety, and to develop food safety indicators of HFS. A cross-sectional study was undertaken. Twenty nine villages were randomly selected from the total number of 299 villages in Thulamela local municipality in the Vhembe District. For proportional sampling of households from the selected villages 4 village clusters were created according to their population sizes. Households were randomly selected from villages. The final randomly selected sample consisted of 335 households with at least 1 child (3-5 years of age) and a caregiver. The caregiver could be the mother of the child or any caregiver over the age of 18 years of age who was mostly responsible for food preparation in the household. A structured interview schedule was used, consisting of questionnaires and data/record sheets that were completed during an interview with the respondent of each household. A sociodemographic questionnaire; food availability and access questionnaire; a food inventory; an 8-item hunger scale; a food frequency questionnaire; a food handling practices questionnaire; and a food handling knowledge test; a 24 hour recall and child health status questionnaire; as well as record sheets were included. Five repeatedly trained (for consistency) field workers (all Nutritionists) collected all types of data. Weight and height status were determined and laboratory techniques were used to determine microbiological content of the water and food samples (114 of 335 of households: 34%) and worm content of stool samples (from all 335 children 3-5 years of age). Data was analysed using statistical analysis software (SAS) version 9.2. Frequencies and percentages were used to describe categorical data. Continuous data (symmetric distributions) were expressed using means and standard deviations while medians, lower and upper quartiles as well as minimum and maximum values were used to describe skewed continuous data. Anthropometric data was summarised using Z-scores. Chi-square tests or Fisher’s exact tests in case of small numbers were used to determine associations 229 between the indicators of household food safety and HFS. A statistical reduction process was used to develop the household food safety indicators that can be used in rural HFS assessments. Household food insecurity was indicated by all indicators used, as well as the sociodemographic indicators. Salary, affordability and the presence of protein rich foods, vegetables, milk and fat were significantly related to the household food security status as indicated by the hunger scale. The levels of food security were evenly distributed among the households: food insecure (32.8%), at risk (37%) and food secure (30.2%) households. However, the anthropometric indicators showed that most children (>88%) had an acceptable weight/height status. The dietary intake of the children suggested sufficient energy intake with probable low intake of micronutrients especially β-carotene. Furthermore, the diet seemed to lack variety, with inadequate intake of fruits, vegetables, milk and dairy products. The health status of the children was apparently good as shown by the less than 20% of children with diarrhoeal episodes and 35.2% with reported worm infestations. Stool examination results also showed few cases of children with worm infestation, Ascaris (1.2%), Trichuris (1.9%) and Giardia lambia (5.6%). In general, caregivers had acceptable scores of self-reported food handling practices and knowledge. Water and food used in the households were both likely to pose a food safety risk in the households respectively. Poor microbial quality was detected in more than 94% of water and 75.9% food samples. Hand-washing water had higher bacterial load than stored water. Both stored and hand-washing water had food safety risk levels of total counts (median = 2.3 x 104 & 2.5 x 105 respectively) and coliforms (median = 5.6 x 104 & 1.6 x 105 respectively). Salmonella and Listeria tested negative on food samples however, coliforms exceeded the safety limits. The presence of E. coli in protein rich foods suggested a faecal pollution. Food handling practices and knowledge were not significantly different in food secure and at risk households but were significantly different in the food insecure households. Self-reported and observed food handling practices did not differ. Availability of protein rich foods including milk in the households was linked to food handling practices, while a significant association was observed between worm infestation in children 3 to 5 years and food handling practices. The microbial quality of stored water was significantly associated with that of hand-washing water. Both stored and hand-washing water were significantly linked with poor microbial 230 quality of left over vhuswa (maize meal porridge) but had no association with fresh vhuswa. Poor microbial quality of fresh and left over vhuswa were significantly related to contaminated protein rich foods. A step by step analysis was done during the development process of food safety indicators, in which indicators that did not show significant associations and did not show sufficient variation were eliminated. In the final step the indicators of household food safety to be included in measuring of HFS in rural households were identified. The food safety indicators identified by this study and recommended for use in measuring rural HFS, include use of stored water, communal hand-washing practices and observed food handling practices. It is recommended that these indicators be evaluated and included in the measuring of rural HFS.