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544 reports · page 54 of 55

Peer-reviewed articleOpenAlex4 Sept 2026

Effect of Pigeon Pea and Sorghum Flour Supplementation on Protein Content, In Vitro Protein Digestibility, and Selected Storage Quality Indicators of Millet Flour Blends

Protein-energy malnutrition (PEM) remains a significant public health issue among children in many parts of Kenya. This study aimed to utilize locally available sorghum, pearl millet, and pigeon peas to develop a protein-rich complementary flour blend that could contribute to efforts to improve the nutritional quality of complementary foods for young children in Tharaka Nithi County, Kenya. The study employed a nested experimental design with pigeon pea level (0, 15, 30, 45, and 60% of the total flour blend) as the main factor and sorghum level (0, 20, and 40% of the remaining flour after pigeon pea addition) nested within each pigeon pea level to evaluate protein content and in vitro protein digestibility of flour blends. An additional factor, storage period (days), was included to assess selected storage quality indicators of the millet-based flour blends during storage. Formulated flour blends were then analysed for protein content, protein digestibility, yeast and mold counts, titratable acidity, and pH. The results revealed that the addition of pigeon peas significantly (p < 0.001) increased the protein content and the digestibility of the flour blends. The average relative humidity and temperature during storage were 55.5% and 25.2 °C, respectively. The addition of pigeon peas to the blends significantly (p < 0.002) increased the titratable acidity of the composite flour blends. The initial mean yeast and mold count was 2.439 ± 0.147 Log CFU/g, which was below the East African Community recommended safety limit for millet flour (4 Log CFU/g). The yeast and mold count slightly increased during storage in the first 16 days, followed by a significant decrease, reaching 1.052 Log CFU/g by day 45. These findings demonstrate the potential of pigeon peas, sorghum, and millet as locally available ingredients for the development of nutritionally improved complementary foods.

Peer-reviewed articleOpenAlex4 Sept 2026

Anemia Prevalence and its Associated Risk Factors using Ten East African Countries: A Recent data from Demographic and Health Survey

Introduction: Anemia, defined as a low level of hemoglobin in the blood, is a sign of inadequate nutrition as well as poor health in children. It affects about 269 million (39.8%) children under the age of five worldwide and it is a significant risk factor for poor health and nutrition in children. The main aim of this study was to assess the prevalence and contributing factors of anemia among children aged 6–59 months in Eastern Africa. Methods: The research was conducted between 2010 and 2023 across ten East African countries. To identify potential factors associated with anemia, a multilevel logistic regression model was used. Results: The prevalence of anemia in Eastern Africa was 54.26%, with the highest in Tanzania (70.32%) and the lowest in Rwanda (36.64%). A multilevel multivariable logistic regression model revealed that factors like child age in months 12-23 (AOR = 0.623; 95% CI: 0.581-0.669), female (AOR = 0.914; 95% CI: 0.880-0.949), stunted (AOR =1.289; 95% CI: 1.234-1.347), underweight (AOR = 1.232; 95% CI: 1.163-1.306), two under-five children (AOR=1.068; 95% CI: 1.023- 1.116), 2-3 birth order (AOR=1.096; 95% CI:1.034-1.162), having fever (AOR=1.410; 95% CI: 1.343-1.481), having diarrhea (AOR=1.066; 95% CI: 1.009-1.125), vitamin A supplementation (AOR =0.899; 95% CI: 0.863-0.937), primary educated mother (AOR=0.819; 95% CI: 0.775-0.865), anemic mother (AOR =1.844; 95% CI: 1.768-1.923), toilet facility (AOR = 0.879; 95% CI = 0.835-0.926), middle wealth index (AOR =0.876; 95% CI: 0.830-0.925), mother had occupation (AOR=0.930;95%CI: 0.892-0.971) and high community poverty (AOR = 1.047; 95% CI: 1.006-1.089) were significantly associated with anemia in Eastern Africa. Conclusion: The prevalence of anemia among children aged 6–59 months was still high in the region, indicating a continuing public health concern. Child age, sex, nutritional status (stunting and underweight), recent illness (feverand diarrhea), maternal education, anemia status, and occupation, household wealth, toilet facilities, vitamin A supplementation, and community poverty levels have statistically significant association with anemia. These findings underscore the urgent need for comprehensive interventions targeting both child nutrition and broader socio-economic and environmental determinants to effectively reduce the burden of anemia in the region.

Denekew Bitew Belay, Nigussie Adam Birhan, Tilahun Yemanu Birhan et al.

SurvivalTZRWRead at source

Peer-reviewed articleOpenAlex6 Sept 2026

Multilevel Modelling of the Factors Associated with Stunting among Under-five Children in Tanzania: A Bayesian Approach

Introduction: In Tanzania, prevalence exceeds 30% and is unevenly distributed across geographical areas. The observed distribution may reflect unobserved contextual factors; however, little literature applies Bayesian multilevel generalised linear mixed (B-MGLM) models, which can account for them. This study aimed to model the determinants of stunting, controlling for contextual factors at both the region and enumeration area levels. Methods: This was a secondary data analysis using four recent Tanzania Demographic and Health Surveys (TDHS) datasets. We studied 7,492, 6,806, 8,929, and 4,797 under-five children in TDHS 2004/5, 2010, 2015/16, and 2022, respectively. We used B-MGLM models to evaluate the determinants of stunting. We used the deviance information criterion to compare the models. Results: About 41.4%, 34.1%, and 28.96% of under-five children were stunted in 2010, 2015/16, and 2022, respectively. Controlling for other factors in the model, a unit increase in MPI increased the odds of stunting by 10% [AOR = 1.1; 95% CI: 1.1, 1.2], while a unit increase in WAMI reduced the odds of stunting by 64% [AOR=0.36; 95% CI: 0.3, 0.4] in 2015/16 and 2010, respectively. Other interesting results were that children with multiple births had 17% [AOR=0.83; 95% CI: 0.7, 0.9] lower odds and 68% [AOR=1.68; 95% CI: 1.5, 1.9] higher odds of stunting in 2004/5 and 2010, respectively. Conclusion: Stunting is associated with individual and contextual factors. Critical efforts should focus on the availability of items that form WAMI and MPI, with greater emphasis on elements that form WAMI because of its consistent negative relationship with stunting across the two surveys. Nutrition education should target working mothers and households with food insecurity.

Edwin Musheiguza, Tukae Mbegalo, Justine N. Mbukwa

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Peer-reviewed articleOpenAlex7 Sept 2026

Relative burden of neglected tropical diseases among school-age children in rural and urban slum settings in Eastern Ethiopia

Abstract Introduction: Despite the determination to succeed in eliminating neglected tropical diseases, these have been increasing within certain endemicities, particularly in depriving region. Objective: This study aimed to assess the relative burden of neglected tropical diseases in rural and urban slum settings in Eastern Ethiopia. Methods: A comparative cross-sectional study was conducted from February 25 to April 30, 2024 with a multistage random sampling technique used. A survey tool with the integration of the spectrum was employed. Data were entered using Epi-Data version 3.1 and analyzed using STATA 16. Descriptive statistics and multivariable logistic regression analysis was used to identify the risk factors and the level for statistical significance was declared at p-value < 0.05 with 95 % CI. Result: The response rate was 93 % and the mean age of house heads was 31.6 (Range; 18. 63) with 5.7 average family size. The overall prevalence of NTDs among study participants was 22.6 % (95% CI; 20.2, 25.2); urban slum it was 15 % (95% CI; 12.2, 18.4) while it was 29.8 % (95% CI; 26, 33.9) in rural. Though there is no statistically significant difference, the relative prevalence of NTDs in rural to urban was two. The multivariable analysis provided that the risk factors associated with NTDs were government employment (AOR: 12.5 (1.17, 132.4)), good income (AOR: 0.13 (.03, 0.57)), Child playing with soil (AOR: 5.8 (1.52, 22.0)); child hand washing at critical times ( AOR: 11.2 (1.7, 74.9)), presence of flies in the child faces (AOR: 20.3 (4.7, 88.6)) and type of drinking water sources (AOR: 0.11 (0.02, 0.73)). Conclusion: the burden of NTDs was moderate in the study area dominated by STH, Trachoma, and scabies. Socio economic and WASH factors were found to be associated with NTDs. Collaborated efforts among stakeholders are crucial to prevent and control NTDs.

Getachew Kabew Mekonnen, Fitsum Weldegebreal, Assefa Desalew et al.

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Peer-reviewed articleCrossref1 Jan 2026

Trends and inequalities in full immunisation coverage among children aged 24 months in Rwanda: evidence from DHS and regional comparisons in Africa (2000–2021)

BackgroundDespite progress, sub-Saharan African countries (SSA) face immunisation disparities. Rwanda has high rates, but the drivers of success are unclear. There's a gap in understanding inequalities and a lack of comparative equity analyses with other SSA countries.MethodsThis study analysed population-based survey data from 17 SSA countries, including Rwanda, among two-year-old children. Full immunisation included all recommended vaccines, according to age and the national immunisation schedule. For Rwanda, the coverage was assessed across six inequality dimensions using frequencies, percentages, and 95% CIs. Absolute (Difference, SII) and relative (Ratio, RCI) measures of inequalities were plotted over time. Population Attributable Risk (PAR) and Fraction (PAF) were estimated for public health impact. Equiplots visualised inequalities across countries.ResultsBetween 2000 and 2019, Rwanda’s full immunisation coverage rose from 76% to 96%. Despite substantial reductions in inequalities in full immunisation coverage in Rwanda between 2000 and 2019, subnational disparities remained the most pronounced, with PAR decreasing from 15.40% to 3.10%, while wealth and place of residence inequalities persisted at low levels (wealth PAR 1.53%; residence PAR 1.43% in 2019). Equiplots highlight that, while Rwanda made significant progress in narrowing gaps across all the equity dimensions, other SSA countries showed wide socioeconomic, educational, and geographic gaps.ConclusionRwanda’s experience with full child immunisation highlights the importance of strong primary healthcare systems and equity-focused delivery strategies, offering transferable lessons for reducing immunisation inequalities across sub-Saharan Africa.

Albert NDAGIJIMANA, Michael Habtu, Theoneste Mutsindashyaka et al.

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Peer-reviewed articleOpenAlex8 Sept 2026

Effect of a Facility-Based Nutrition Education Intervention on Nutritional Status of Children Aged 6–23 Months: A Longitudinal Quasi-Experimental Study in Nyeri County, Kenya

Childhood malnutrition remains a major public health challenge in low- and middle-income countries, contributing substantially to morbidity and mortality among children under five. Although nutrition education is widely promoted to improve infant and young child feeding practices, evidence on its effects when delivered through routine health services in Kenya over a nine-month period remains limited. This study evaluated the effect of a structured facility-based nutrition education intervention comprising interactive group sessions with practical food demonstrations on the nutritional status of children aged 6-23 months in Nyeri County, Kenya. A longitudinal quasi-experimental study was conducted between May 2021 and March 2022 in two purposively selected Level IV hospitals (Karatina, intervention; Othaya, control). A total of 451 mothers, each paired with one child (220 intervention, 231 control), were enrolled and followed for nine months (360 retained). Mothers in the intervention arm attended three quarterly sessions of about 60-75 minutes, each pairing interactive learning with hands-on food demonstrations using locally available ingredients and content drawn from the Kenya Ministry of Health Infant and Young Child Nutrition counselling cards. Mothers in the control arm received the facility's routine maternal and child health education. Children's anthropometry was measured at baseline and at 3, 6, and 9 months, and weight-for-length, weight-for-age, and length-for-age Z-scores were derived against the WHO Child Growth Standards to classify wasting, underweight, and stunting. Because each child was measured repeatedly, intervention effects were assessed primarily using generalized estimating equations (GEE) modelling the arm × time interaction, supported by prevalence changes, net intervention effects, and chi-square or Fisher's exact tests, with significance set at 5%. The two arms were comparable in nutritional status at baseline. By nine months, the prevalence of wasting declined from 7.3% to 4.1% in the intervention arm compared with 8.5% to 8.3% in the control arm (net intervention effect − 3.0 percentage points). Generalized estimating equations that accounted for repeated measures within children showed no statistically significant arm × time interactions for wasting (OR 1.01, 95% CI 0.94–1.09, p = 0.73), underweight or stunting. A structured facility-based nutrition education programme integrating food demonstrations was associated with a favourable but non-significant reduction in wasting over the nine-month period. Nutrition education should be strengthened alongside nutrition-sensitive interventions, including improved household food security, water, sanitation and hygiene, and social protection programmes, to achieve sustained improvements in child nutritional status. Key words:nutrition education; facility-based; child nutritional status; quasi-experimental study; net-effect intervention; generalized estimating equations; Nyeri; Kenya

LA Omondi, JK Mutai, SM Kilonzi et al.

SurvivalExperimentalKERead at source

Peer-reviewed articleOpenAlex8 Sept 2026

Dietary diversity and maternal perspectives of indigenous food consumption among infants in Kitui county, Kenya

Inroduction Maternal perceptions of indigenous foods and dietary diversity are crucial in shaping infant nutrition and preserving cultural food practices. Addressing these perspectives is vital to overcoming local nutritional challenges. This study investigated mothers’ perception on indigenous foods and their inclusion in the diets of infants aged 6 to 23 months in Kitui County, Kenya. Study also, examined the association between infants’ dietary diversity and maternal perceptions on indigenous foods. Methods In this cross-sectional study, 402 infant-mother pairs were enrolled. Dietary diversity was assessed using a dietary diversity questionnaire. Mothers provided insights into their perceptions regarding indigenous foods. Results and discussion The average dietary diversity score for the infants was low at 2.47 ± 0.02, with only 30.3% consuming more than four food groups in the past 24 h. About 36.6% of mothers reported that their infants accepted/liked indigenous foods whereas 94.5% considered them expensive, 59.2% perceived them as nutritious/health. Additionally, only 4.7 and 17.4% of mothers indicated that indigenous foods were readily available and easy to prepare, respectively. Dietary diversity was significantly associated with infant acceptance of indigenous food ( p = 0.021), perceived nutrition/health benefit ( p < 0.001), availability ( p = 0.016) and ease of preparation ( p < 0.001). Key predictors of indigenous food consumption included infants’ acceptance of the foods, affordability, perceived nutritional benefits, availability, and ease of preparation. Multi-level interventions targeting food production, intrahousehold food security, and maternal nutrition behaviors, such as providing appropriate recipes, cooking training, and demonstrations, could promote the consumption of nutrient-rich indigenous foods. Enhancing the accessibility and availability of these foods is crucial. This can be achieved by supplying quality seeds, climate-resilient livestock breeds, essential farm inputs, water harvesting technologies, and providing extension support services. These measures could bolster indigenous food production and intake, thereby improving infant nutrition.

Jane Mbijiwe, Dickens Omondi

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Peer-reviewed articleOpenAlex11 Sept 2026

Continuous age-dependent centile curves and preliminary reference intervals for renal biomarkers and electrolytes in healthy Kenyan children under five years

Renal biomarkers change rapidly in early childhood, but pediatric reference intervals used in African laboratories are often extrapolated from non-African populations and discrete age partitions. This study derived continuous age-dependent centile curves and preliminary reference intervals for body mass index (BMI), serum creatinine, urea, and electrolytes in healthy Kenyan children aged 0 to 60 months. In this cross-sectional study, 176 children (90 males, 86 females) were systematically recruited at Kitui County Referral Hospital between June 2024 and February 2025. Children underwent clinical screening, World Health Organization-standard anthropometry, and morning fasting venous blood sampling. Creatinine and urea were measured using isotope-dilution mass spectrometry-traceable enzymatic assays, and electrolytes by direct ion-selective electrode. Centiles (2.5th, 50th, 97.5th) were estimated non-parametrically with 90% bootstrap confidence intervals, and continuous age trends modeled using generalized additive models for location, scale, and shape or quantile regression. BMI showed modest age-related variation, with median values rising from 15.8 kg/m2 (2.5th-97.5th: 11.4-20.2) at 0 to 11 months to 16.5 kg/m2 (10.1-23.0) at 48 to 60 months, with dispersion narrowing after age 2. Median creatinine rose steeply in infancy and more gradually thereafter, from 17.4 to 31.2 µmol/L. Urea increased gradually from a median of 2.59 to 3.63 mmol/L, with overlapping centile limits across adjacent strata. Electrolytes were tightly regulated and largely age-invariant: sodium ranged from 135 to 147 mmol/L (median ~141), potassium 3.6 to 5.7 mmol/L (median declining from 4.9 to 4.5), and chloride 100 to 111 mmol/L (median ~105-106). Sex-specific partitions were supported only in early life (BMI in infancy, creatinine in toddlers); correlations between anthropometric z-scores and biomarkers were weak (|ρ| < 0.15; P > .10). These continuous centile curves provide the first preliminary age-dependent reference estimates for renal biomarkers in Kenyan children under 5, showing rapid early renal maturation alongside stable electrolyte homeostasis. As this cross-sectional design cannot capture within-subject variation, larger multicenter and longitudinal studies are needed to confirm these trajectories, refine intervals, and develop age-dependent z-score calculators for clinical use.

Brian Nganda, Peter Karanja, Kennedy Muna et al.

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Peer-reviewed articleOpenAlex13 Sept 2026

Household Food Insecurity, Fruit and Vegetable Intake, and Child Nutritional Status in Nyamagabe District, Rwanda: A Convergent Parallel Mixed-Methods Study

Malnutrition among children is a serious health problem in Rwanda, with 33 percent of children under five being stunted. Limited dietary diversity, especially fruits and vegetables, contributes to micronutrient deficiencies and growth retardation. This research examined fruit and vegetable intake trends and relationships with the nutritional status of 6-59-month-old children in Nyamagabe District, Southern Province, Rwanda. Data collection occurred between November 2025 and February 2026 using a mixed-method convergent parallel design. The quantitative element included a community survey of 513 mother-child pairs through multistage cluster sampling. Anthropometric values were recorded per WHO protocol, and dietary intake was collected through 24-hour recalls, food questionnaires, and diversity scores. Food security was measured using the Food Insecurity Access Scale. The qualitative element included 17 focus groups and 20 in-depth interviews. The stunting, wasting, and underweight prevalence were 39.2, 3.5, and 12.1, respectively. Only 28.7 percent of children had minimum dietary diversity, with daily fruit and vegetable intake at 1.6 servings (SD = 1.3). Children consuming three or more servings were less likely to be stunted (AOR = 0.38; 95% CI: 0.24-0.61; p < 0.001) and underweight (AOR = 0.47; 95% CI: 0.27-0.83; p = 0.009). Household food insecurity was strongly associated with increased stunting risk (AOR = 3.45; 95% CI: 2.18–5.47; p < 0.001), indicating that food-insecure households had nearly 3.5 times greater odds of having a stunted child compared to food-secure households. Absence of formal maternal education (AOR = 2.67; 95% CI: 1.58–4.51; p < 0.001) and belonging to the lowest wealth quintile (AOR = 2.89; 95% CI: 1.72–4.86; p < 0.001) were additional independent risk factors for stunting. Barriers included seasonal deficits, high prices, weak nutrition education, and a preference for starchy staples. Solutions require nutrition-sensitive agriculture, year-round food production, behavior change, and food security programs.

Gisubizo Fabien, Irène Médémè Mitchodigni, Evode Habimana et al.

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Peer-reviewed articleOpenAlex14 Sept 2026

Development and nutritional evaluation of an extruded grain amaranth-instant porridge as a supplementary food for children under five with moderate acute malnutrition

Moderate acute malnutrition (MAM) among children under five remains a challenge in Tanzania, where the fortified blended foods used to manage it are almost entirely imported, expensive and inaccessible. This study developed and evaluated a grain amaranth-based extruded instant porridge as a locally sourced alternative. Five formulations were generated from grain amaranth, pro-vitamin A maize, soybean and sesame by two-stage linear programming using regional food composition data, with crude protein maximized subject to a technological fat ceiling of 11.0 g/100 g. Formulation 1, the least-cost solution, and Formulation 5, the most nutrient-dense within fat ceiling that is more economical than the non-compliant Formulation 3, were advanced to twin-screw extrusion. Proximate composition (AOAC 2005), mineral content (microwave plasma atomic emission spectrometry) and anti-nutritional factors (colorimetric methods) were determined; functional and sensory properties were evaluated; data were analyzed by ANOVA. Protein ranged from 18.14 g/100 g in Formulation 1 to 20.53 g/100 g in Formulation 5 reaching 98.0% of the WFP/UNICEF Super Cereal Plus (CSB++) minimum of 400 kcal/100 g. Formulation 5 showed the highest fat (11.95 g/100 g) and zinc (8.98 mg/100 g), all within CSB++ ranges, with only potassium below specification (37.1%). Extrusion significantly increased water absorption capacity ( p < 0.001), shifted the flour from the fair to good flowing category, and reduced tannins, oxalates and phytate by 50.2, 64.9 and 77.6% relative to raw grain amaranth. Sensory scores showed good overall acceptability (6.2–6.9), with significant differences for aroma ( p < 0.001) and flavor ( p = 0.002); SC(F5)-777 ranked highest among extruded samples. Food-to-food fortification using grain amaranth at 40–45% produced energy- and nutrient-dense instant porridge with improved mineral content, functional properties, and sensory characteristics, demonstrating strong potential for use as locally available supplementary food for managing MAM in children under five.

Amos Steven Mwikwabe, Haikael David Martin, Benson Kusirie Mushi et al.

SurvivalTZRead at source

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