Masters Degrees (Nutrition and Dietetics)

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Browsing Masters Degrees (Nutrition and Dietetics) by Subject "Anthropometry"

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    Causes of malnutrition in Mangaung
    (University of the Free State, 2005) Pienaar, Michelle; Walsh, C. M.; Dannhauser, A.
    English: Malnutrition is often a silent and invisible problem and its persistence has profound and devastating implications for children, society and the future of humankind. While good nutrition is extremely important for a healthy lifestyle and quality of life, the effects of poor nutrition are devastating. Before interventions can be implemented however, it is essential to determine the specific causes of malnutrition in a community. The community of Mangaung is a rapidly urbanizing community where the double burden of malnutrition and diseases of lifestyle occur simultaneously. The causes of malnutrition are seen as deeply rooted in environmental factors, such as poverty and lack of education. In any attempt to improve nutritional status it is therefore important to assess the relationship between certain environmental factors and nutritional status indicators. The aim of this study was to assess nutritional status (anthropometric status and dietary intake) and household resources (household and parent/caregiver particulars), in an attempt to identify specific issues that play a role in the development of malnutrition. The main objective of this study was thus to provide baseline data on causes of malnutrition in two areas of Mangaung, namely JB Mafora and Namibia. Household information and socio-demographic status were determined by means of a questionnaire completed in an interview. BMI of caregivers and weight-for-age, height-for-age and weight-for-height of children younger than six years were obtained using standard techniques. Dietary intake was determined by a questionnaire during an interview. The results in the study identified a number of socio-demographic factors associated with malnutrition. A concerning percentage of households had no income and in most households only one person contributed to income. Although a large proportion of breadwinners in the study areas were employed, a large proportion of household members where either unemployed or were dependent on another source of income, i.e. pension. In a large proportion of households, none of the women used any family planning. The percentage of respondents who ever attended clinics, were high. Level of education of household members older than 18 years showed that only a few of household members received education on tertiary level, while more than ten percent had no schooling. Regarding medical conditions a significant amount of household members indicated hypertension. As expected, diarrhea, loss of appetite and weight loss was generally more prevalent in underweight caregivers, but differences were not statistically significant. The prevalence of overweight and obesity in the studied group of household members was an outstanding anthropometric feature, with almost half of caregivers falling in the overweight or obese categories. Results of this study indicated that the number of well-nourished children in this study was small. The percentage of underweight children (17%) was higher when compared with the NFCS (1999), while a large percentage (30.3%) of children were stunted. As expected, a much smaller percentage of children (9.2%) in the study had a reduced weight-for-height than a weight-for-age or height-for-age. A relatively large proportion of the respondents did not consume foods from all three groups during each meal. Almost all adults did not consume a balanced breakfast, the majority did not include all three food groups for lunch and more than half did not have a balanced supper. In the case of children, a high percentage did not eat a balanced diet. In the case of babies (between birth and six months), results showed that approximately 80.0% of babies received a well balanced diet throughout the day. This is due to the high percentage of mothers who exclusively breastfed their babies. With the view to implementing a relevant nutrition education intervention program in Mangaung in the future, this base-line study (2004) was considered essential. Findings on the existing nutritional status and specific causes of nutritional problems of the community of Mangaung, can make a meaningful contribution to the design of effective nutrition intervention programmes.
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    ItemOpen Access
    Effectiveness of the prevention of mother-to-child transmission (PMTCT) policy in the Northern Cape, South Africa
    (University of the Free State, 2015-07) Myburgh, Bianca; Lategan, Ronette
    English: Introduction Human Immunodeficiency Virus (HIV) infection in children is mainly caused by Mother-to-Child Transmission (MTCT). The Prevention of Mother-to-Child Transmission (PMTCT) policy has been implemented in South Africa to reduce the rate of MTCT. Even though this policy has been in place for more than ten years and despite the reduction in MTCT, the challenge remains to eliminate MTCT completely. This study investigates the factors that may influence the effectiveness of the PMTCT policy. Methods Four clinics in the Frances Baard District, South Africa, where PMTCT services are rendered were included. A hundred mothers-child-pairs, where the mother is HIV infected and breastfed her child, but has stopped breastfeeding and the six week post cessation of breastfeeding HIV test was done on child, were included in the study. A questionnaire was completed by the researcher during an interview with the mother and anthropometric measurements of both mother and child were taken. The clinic files of mothers were also used to collect data. Ethical approval to conduct this study was obtained from the Ethics Committee, Faculty of Health Sciences, University of the Free State and the Northern Cape Department of Health Research Ethics Committee. Mothers provided informed consent before interviews were conducted. The Department of Biostatistics, University of the Free State performed the statistical analysis of data. Results All mothers included in this study attended antenatal clinics. Mothers who were not known to be HIV infected were tested antenatal and CD4 cell counts and HIV stages were indicated in all files. Twenty two mothers visited the antenatal clinic less than four times as recommended and 23 mothers visited for the first time during their third trimester. Only one mother reported that she received no counselling on feeding practises, and even though mothers were mostly knowledgeable about feeding practices, only 58 mothers introduced solids at the correct age and 31 mothers mixed fed their children.The number of counselling sessions did not affect breastfeeding duration (95% CI: [-2; 3]) or the age of introduction of solids (95% CI:[-2; 1]) Knowledge about MTCT was poor as most mothers (82%) only knew that MTCT could occur during breastfeeding. Younger mothers were more knowledgeable (95% CI: [0.17; 5.56]). The number of counselling sessions did not affect the knowledge of the mother (p=0.12). Five children and eight mothers never started with any antiretroviral therapy (ART). Thirteen children and 27 mothers defaulted their ART treatment. No children tested HIV infected at six weeks but three children tested HIV infected at the 18 month test. Mothers with HIV infected children had a more advanced stage of HIV infection (95% CI: [23.5%; 87.1%]), lower CD4 cell count (p=0.03) and defaulted their ART during breastfeeding (95% CI: [21.5%; 85.4%]) compared to mothers with HIV uninfected children. All three children that tested HIV infected were of mothers with Stage 2 HIV infection, with a CD4 cell count of less than 350 cells/mmᶾ and defaulted their ART during breastfeeding. Conclusions and recommendations Using the 2010 and 2013 PMTCT policies as benchmark, the PMTCT programme is implemented relatively well in this district although improvements still need to be made. The knowledge of the mothers about feeding practices and MTCT should be addressed by means of counselling by properly informed health care professionals. Missed opportunities for training resulted, as mothers did not attend antenatal clinic as soon and as often as recommended. Mothers should be motivated to improve ART adherence as this can affect CD4 cell count and HIV progression, all factors that contributed to MTCT. Counselling should be focussed on ART adherence and MTCT. Shortages of ART at clinics should be addressed to eliminate this reason for ART defaulting. All women of childbearing age should also be made aware of the importance of early antenatal attendance. The rate of HIV transmission in this district is below the national reported rate but it remains a challenge to eliminate MTCT completely.