Browsing by Author "Mwanri, Akwilina Wendelin"

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Association between dietary diversity with overweight and obesity: A cross-sectional study conducted among pastoralists in Monduli District in Tanzania
(Plos One, 2021) Khamis, Ahmed Gharib; Ntwenya, Julius Edward; Senkoro, Mbazi; Mfinanga, Sayoki Godfrey; Kreppel, Katharina; Mwanri, Akwilina Wendelin; Bonfoh, Bassirou; Kwesigabo, Gideon
Background The prevalence of overweight and obesity is rising at a rapid pace and is associated with negative health consequences like cardiovascular diseases, type 2 diabetes and cancer. Obesity is a multifactorial problem that develops mainly from lifestyle factors including physi- cal inactivity and poor dietary intake. Dietary diversity is a simplified method for assessing the adequacy and quality of diet and is associated with nutritional need and overall health status. Therefore, we conducted this study to synthesize the associations between con- sumption of a diversified diet and overweight/ obesity among adults living in pastoral com- munities in Monduli district in Tanzania. Methods This was a cross-sectional study conducted among 510 adults aged � 18 years old in the Monduli district, Arusha region in Tanzania. We conducted face-to-face interviews to collect information about socio-demographic characteristics, 24-hours dietary recall, and anthropo- metric measurements. The dietary diversity score (DDS) was constructed and used to determine the diversity of the diet consumed. We performed the multivariate Poisson regressions to determine the prevalence ratio (PR) with 95% confidence intervals (CI). The dependent variables were overweight and general obesity as measured by body mass index (BMI), abdominal obesity measured by waist-hip ratio (WHR) and waist circumference (WC). Results The prevalence of general obesity based on BMI was 20.2% (95%CI; 16.9–23.9), abdominal obesity based on WHR was 37.8% (95%CI; 33.7–42.1), and WC was 29.1% (95%CI; 25.2– 33.1). More than half (54.3%) of the participants consumed an adequate dietary diversity (DDS �4). After adjustment for potential confounders, the prevalence of abdominal obesity by WHR decreased with higher DDS among male (APR = 0.42; 95% CI, 0.22–0.77) and female participants (APR = 0.63; 95% CI, 0.41–0.94). There were inconsistent positive associations between DDS and prevalence of overweight and general obesity among male and female. There was no association between DDS and abdominal obesity by WC. Conclusion More than half of the pastoralists have consumed an adequate diversified diet. Given the inconsistent findings on associations between dietary diversity and obesity measures, this study suggests that targeting dietary diversity as an overweight/obesity prevention strategy requires careful consideration.
The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure
(BMC Nutrition, 2020) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Kreppel, Katharina; Kwesigabo, Gideon
Background: Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under-five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to ameliorate all form of childhood undernutrition in the country. Methods: About 37,205 mother-child pairs were retrieved and analyzed from the Tanzania Demographic and Health Surveys (TDHS) conducted in various years from 1991, 1996, 1999, 2004–05, 2009–10, to 2015–16. The anthropometric data of children under-five years were used to determine the overall burden and trends of undernutrition using CIAF. The recent TDHS surveys from 2005 to 2015 were used to examine the correlates of CIAF. To determine the correlates, multivariate analysis was conducted to estimate the prevalence ratios (PR) with 95% confidence intervals (CI) using Poisson regression with robust variance. Results: The prevalence of CIAF declined significantly from 50% in 1991 to 38.2% in 2015 (p < 0.001). The correlates of CIAF vary across surveys. The multivariate analysis of recent 2015 survey revealed that the prevalence of CIAF was significantly higher for older children (p < 0.001), children living in rural areas (p = 0.028), and those born with non- educated (p = 0.009) or single mothers (p = 0.008). The prevalence of CIAF was significantly lower for girls (p < 0.001), being born with overweight/obese mothers (p < 0.001), living with older head of the household (p < 0.001) or living in richest household (p < 0.001). Moreover, children who were born with low birth weight (p < 0.001), or having fever (p = 0.044) were most likely to have anthropometric failure. However, consumption of diversified diet was not found to be associated with anthropometric failure (p > 0.05). Conclusion: About one in every three under-five years children are suffering from either one or multiple forms of anthropometric failure in Tanzania. There is a significant decline trends in overall burden of undernutrition in Tanzania from the past 25 years, as measured by CIAF. Multiple factors including those related to mothers, children and household socio-economic characteristics have the potential to influence childhood undernutrition. Efforts to reduce the burden of undernutrition should mainly focus on reducing poverty and raising people’s living standards.
Compliance to recommended prevention and management practices among type 2 diabetes patients in Morogoro municipality, Tanzania
(Tanzania Journal of Health Research, 2024-04-02) Bofu, Hasna; Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Introduction: Diabetes-related complications are the significant causes of morbidity and mortality among type 2 diabetes patients. The complications can be reduced by practising and maintaining several preventive measures. The present study aimed to assess compliance and factors associated with recommended management practices and prevention of complications among type 2 diabetes patients in selected health facilities in Morogoro Municipality, Tanzania. Methods: A hospital-based cross-sectional study was conducted from February to May 2023 among 140 patients diagnosed with diabetes for at least three months before the study. Data were collected through face-to-face interviews using a structured questionnaire, which included patients’ characteristics and a previously validated Summary of Diabetes Self-care Activities questionnaire to assess patients' compliance with recommended practices. A multi variable regression analysis was employed to identify factors associated with compliance with recommended practices. Results: The mean age of the respondents was59 ±12.08 years and 65% were females. Among 140 patients, 91.4% (n=128) had poor or unsatisfactory self-care practices with an overall mean of 3.81± 2.08 days per week for diabetes management. The recommended practices with good or satisfactory performance were non-smoking, non-alcohol drinking and prescribed medication. In contrast,unsatisfactory performance was observed for self-monitoring blood glucose and physical activities. Multiple regression analysis showed that co-morbidity (AOR 4.5; 95% CI: 1.14-18.02) and being employed (AOR 4.4; 95% CI:1.25-15.44) independently predict self-care practices. Conclusion and recommendation: Compliance with self-monitoring of blood glucose, physical exercise and dietary practices were found to be low among type 2 diabetes patients, which could increase the risk of complications. Nutritional and lifestyle counselling and the use of peer groups should be emphasized to improve compliance with recommended practices.
Design and validation of a food frequency questionnaire to assess the dietary intake for adults in pastoral settings in Northern Tanzania
(BMC Research Notes, 2021) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Ntwenya, Julius Edward; Senkoro, Mbazi; Kreppel, Katharina; Bonfoh, Bassirou; Mfinanga, Sayoki Godfrey; Kwesigabo, Gideon
Objective: Food frequency questionnaires are widely used as a dietary assessment tool in nutritional epidemiol- ogy to determine the relationship between diet and diseases. In Tanzania, there are several cultural variations in food intake which makes it necessary to design and validate a culture-specific food frequency questionnaire (CFFQ). There- fore, we designed a 27-items CFFQ and examine its validity in pastoral communities. Validity of CFFQ was assessed by comparing nutrient intake estimated from the CFFQ against the average from two 24-h diet recall (2R24). Spearman’s correlation coefficients, cross classification and Bland–Altman’s methods were used to assess the validity of CFFQ. Results: A total of 130 adults aged 18 years and above completed both CFFQ and 2R24. Correlation coefficients between CFFQ and 2R24 ranged from low (r = − 0.07) to moderate (r = 0.37). The correlation coefficients were mod- erately significant for kilocalories (r = 0.31, p < 0.001), carbohydrate (r = 0.33, p < 0.001), magnesium (r = 0.37, p < 0.001), and iron (r = 0.34, p < 0.001). On average, about 69% of participants were correctly classified into the same or adjacent quartile of energy and nutrient intake, while 9% were misclassified by the CFFQ. Bland–Altman’s plot demonstrated that the CFFQ had acceptable agreement with the 2R24.
Dietary intake of omega-6 and omega-3 fatty acids among pregnant and breastfeeding women in Morogoro, Tanzania
(Academic Journals, 2023-10-26) Tesha, Tesha Anna Peter; Mwanri, Akwilina Wendelin; Nyaruhucha, Cornelio
A new-born’s health and wellbeing is determined by the diet and lifestyle of the mother prior, during and after conception. Polyunsaturated fatty acids play an important role for proper development of brain and other organs in the body. This study sought to assess dietary intake of omega 6 and omega 3 fatty acids among pregnant and breastfeeding women in Morogoro municipality, Tanzania. About 318 women completed a repeated 24 h dietary recall questionnaire. For calculation of fatty acid intake, the foods consumed by each participant were entered independently in Nutri Survey software where the amount of nutrients consumed by each individual was calculated and then exported to SPSS for further analysis. The results showed high intake of non-alcoholic and carbonated beverages (213.4 g/day) and low intake of omega 6 and omega 3 rich foods (54.6 g/day). More than half could not attain the recommended minimum dietary diversity score. The average intake of important omega 6 and omega 3 fatty acids ranged from 0.06 to 1.19 g/day and 0.17 to 0.25 g/day, respectively. When compared with the recommended intake of energy as well as important omega 6 and omega 3 fatty acids for both pregnant and breastfeeding women, there were gaps in all of these aspects. Intake of omega 6 and omega 3 rich foods among pregnant and breastfeeding women was lower than recommended. Nutrition education on consumption of appropriate polyunsaturated fatty acid rich foods prior, during and after pregnancy should be given to all women of reproductive age.
Dietary patterns, nutrient intakes and metabolic conditions among agro-pastoralists in Monduli District, Tanzania
(Dovepress, 2022) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Senkoro, Mbazi; Kreppel, Katharina; Bonfoh, Bassirou; Mfinanga, Sayoki Godfrey; Kwesigabo, Gideon
Background: Unhealthy dietary patterns have contributed to the increase in metabolic syndromes in Tanzania. This study aimed to examine dietary patterns, nutrient intakes and investigate the association with obesity and high blood pressure among adults in agro- pastoral communities in Monduli district, Tanzania. Methods: We conducted a cross-sectional study involving 283 adults aged from 18 years old. Blood pressure and anthropometry were measured from each participant. Dietary intake was assessed using a validated food frequency questionnaire. Principal component analysis was used to identify types of dietary patterns. Logistic regression model was used to examine the associations. Results: Three types of dietary patterns were identified labeled as maize, beans and dairy; meat based; and fruits and vegetables. Higher intake of carbohydrates was found in maize dietary pattern. Meat dietary pattern was associated with higher intake of calcium and protein. Higher intakes of fiber and vitamin B2 was found in the fruits and vegetables dietary pattern. Participants on the third quartile of the maize pattern had higher odds of abdominal obesity (AOR=2.81; 95% CI: 1.09–7.26). Participants in the third and fourth quartiles of meat based pattern had increased odds of abdominal obesity by five (AOR=5.03; 95% CI: 2.31–10) and three folds (AOR=3.07; 95% CI: 1.36–6.92). Participants in the third quartile of fruits and vegetables dietary pattern have lower odds of general obesity (AOR = 0.25, 95% CI: 0.07, 0.9) and abdominal obesity (AOR = 0.25, 95% CI: 0.09, 0.71). No association between dietary patterns and high blood pressure was observed. Conclusion: Three dietary patterns were identified in agro-pastoral communities. This study suggests that higher adherence to maize, beans and dairy dietary pattern and meat based dietary pattern may increase the risk of general and abdominal obesity. The fruits and vegetables dietary pattern may prevent from obesity. Further investigation is recommended to guide the preventive nutrition interventions.
Fruit consumption and storage practices among rural households in Chamwino district, Dodoma, Tanzania
(Academicjournals.org/AJFS, 2023-05) Chove, Lucy Mlipano; Mwanri, Akwilina Wendelin; Ngawembela, Mwanaisha Assim
Fruit consumption is still a challenge in many parts of Africa, and hence micronutrient deficiency continues to be a serious problem in the continent. This study was conducted between December 2017 and May 2018 in Chinoje and Mzula villages in Chamwino district, Dodoma to assess availability of fruit, consumption, storage practices and nutrient content. People responsible for food preparation were interviewed from 345 randomly selected households by using semi-structured and food frequency questionnaires. Multiple logistic regression model was used to determine the relationship between frequency of fruit consumption and household socio-economic features by using SPSS. Laboratory analysis was conducted to determine nutrient content of baobab, which was the most consumed fruit. Analysis of Variance (ANOVA) was used to determine if significant variations existed in the nutritional quality of baobab fruit by using SAS. Only 35% of the households consumed fruit daily, while the majority consumed fruit from one to three days in a week. Monthly income, household size and headship significantly affected fruit consumption at p<0.05. Most of the baobab fruits were stored in polypropylene sacks (77.4%), followed by plastic buckets (3.3%) and others as shelled fruit (18.4%). Significant losses in Vitamin C and total carotenoids were observed in baobab fruits that were stored in sacks. Storage of baobab fruit in plastic bucket is recommended for quality maintenance of nutrients.
Fruit consumption and storage practices among rural households in Chamwino district, Dodoma, Tanzania
(African Journal of Food Science, 2023-07) Ngawembela, Mwanaisha Assim; Mwanri, Akwilina Wendelin; Chove, Lucy Mlipano
Fruit consumption is still a challenge in many parts of Africa, and hence micronutrient deficiency continues to be a serious problem in the continent. This study was conducted between December 2017 and May 2018 in Chinoje and Mzula villages in Chamwino district, Dodoma to assess availability of fruit, consumption, storage practices and nutrient content. People responsible for food preparation were interviewed from 345 randomly selected households by using semi-structured and food frequency questionnaires. Multiple logistic regression model was used to determine the relationship between frequency of fruit consumption and household socio-economic features by using SPSS. Laboratory analysis was conducted to determine nutrient content of baobab, which was the most consumed fruit. Analysis of Variance (ANOVA) was used to determine if significant variations existed in the nutritional quality of baobab fruit by using SAS. Only 35% of the households consumed fruit daily, while the majority consumed fruit from one to three days in a week. Monthly income, household size and headship significantly affected fruit consumption at p<0.05. Most of the baobab fruits were stored in polypropylene sacks (77.4%), followed by plastic buckets (3.3%) and others as shelled fruit (18.4%). Significant losses in Vitamin C and total carotenoids were observed in baobab fruits that were stored in sacks. Storage of baobab fruit in plastic bucket is recommended for quality maintenance of nutrients.
The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania
(BMC Pediatrics, 2019) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Ntwenya, Julius Edward; Kreppel, Katharina
Background: Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes for undernutrition. As dietary diversity is a major requirement if children are to get all essential nutrients, it can thus be used as one of the core indicators when assessing feeding practices and nutrition of children. Therefore, adequate information on the association between dietary diversity and undernutrition to identify potential strategies for the prevention of undernutrition is critical. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015–2016, we carried out secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight. Results: A total of 2960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). The remaining food groups were reported to be consumed by a much lower proportion of children, including eggs (7%), meat and fish (36%), milk and dairy products (22%), as well as legumes and nuts (35%), and other vegetables (21%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR = 1.37, 95% CI; 1.13–1.65) and underweight (AOR = 1.49, 95% CI; 1.15–1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children. Conclusion: Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.
Insulin resistance among pregnant women in urban areas of Arusha region, Tanzania
(Mary Ann Liebert, Inc., 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Aim: To establish the prevalence of insulin resistance (IR) and its determinants among selected pregnant women in urban Arusha for taking preventive measures. Methods: A cross-sectional study was conducted between March and December 2018 at Ngarenaro and Kaloleni health facilities in Arusha District involving 230 randomly selected pregnant women who were not known to have diabetes before pregnancy. Blood glucose at fasting and 2 hr after consuming 75 grams of glucose dissolved in 300 mL of water was measured using Gluco-Plus , serum insulin concentrations using ELISA machine (Synergy/HTX ; BioTek), and IR was calculated using the Homeostasis Model of Assessment formula. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regular tape, weight using SECA , blood pressure using GT-868UF Geratherm machine, and height by stadiometer. Maternal characteristics were collected through face to face interviews using a structured ques- tionnaire. Data were analyzed using the Statistical Package for Social Science Version 20. Results: The prevalence of IR was 21% (n = 49) and significantly associated with increased body fat percentage (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.01–2.5), family history of Type 2 diabetes mellitus (T2DM; AOR: 2.77, 95% CI: 1.21–6.33), hypertension (AOR: 2.5, 95% CI: 1.12–5.6), edema (AOR: 3.01, 95% CI: 1.31–6.96), and proteinuria (AOR: 3.44, 95% CI: 1.11–10.69). Conclusions: IR was higher among pregnant women with increased body fat percentage, family history of T2DM, hypertension, edema, and proteinuria. These findings call for large-scale screening to further explore risk factors to prevent gestational diabetes mellitus.
Postpartum hyperglycemia and pregnancy outcomes among women in Arusha Region, Tanzania
(AJOL, 2022) Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Background: Gestational diabetes mellitus is a medical condition that disappears after delivery if early diagnosis and management are done. This study aimed to determine the prevalence of hyperglycemia six weeks postpartum and pregnancy outcomes among women in Arusha City. Methods: A longitudinal study was conducted between March and December 2018 as part of a large study which involved 468 randomly selected pregnant women and excluded those who were diagnosed with diabetes before pregnancy. Women were screened for hyperglycemia six weeks postpartum where fasting and oral glucose tolerant tests were done by Gluco-PlusTM using World Health Organization criteria. Body fat percentage, mid-upper arm circumference, height and weight were measured using standard procedures. Postpartum information was collected using a structured questionnaire and data was analyzed using the Statistical Package for Social Science version 20 to obtain descriptive and inferential statistics. Results: Among 468 women who participated in the study at baseline, 392 (83.7%) returned for postpartum assessments. Postpartum hyperglycemia among women was 2.1% (n=8) and majority had normal delivery (92.6%, n=363) while 7.4% (n=29) delivered through caesarean section. About 8.2% (n=32) of the newborn were macrosomia and 4.1% (n=16) low birth weight. Miscarriages or abortions were not identified while stillbirth was observed in 0.5% (n=2) and neonatal death (1.3%, n=5). Postpartum hyperglycemia was significantly associated with body fat percentage (AOR 1.59, 95% CI: 1.14-1.91), mid-upper arm circumference (AOR 1.62, 95% CI: 1.023-1.99), macrosomia (AOR 2.43, 95% CI: 2.2-10.31) and family history of type 2 diabetes (AOR 6.4, 95% CI: 1.93-13.3). Conclusion: Prevalence of postpartum hyperglycemia was generally low however; it was significantly associated with macrosomia, increased body fat percentage, mid-upper circumference and family history of type 2 diabetes. Also, a low prevalence of poor pregnancy outcomes was reported which may be attributed to actions taken after being referred for further treatments and management which need further exploration.
Prevalence and determinants of hypertension among pastoralists in Monduli District, Arusha region in Tanzania: a cross-sectional study
(BMC/ Archives of Public Health, 2020) Khamis, Ahmed Gharib; Senkoro, Mbazi; Mwanri, Akwilina Wendelin; Kreppel, Katharina; Mfinanga, Sayoki Godfrey; Bonfoh, Bassirou; Kwesigabo, Gideon
Background: Hypertension is among the growing non-communicable diseases (NCDs) in developing countries and the leading cause of death worldwide. Pastoral areas have been identified to be at a higher risk of diseases due to challenges in their daily food production, livelihoods or mobility. Unfortunately, the prevalence of hypertension and the risk factors particularly affecting rural and pastoral populations are not fully understood, making intervention efforts challenging. The aim of this study was to determine the prevalence of hypertension and identify the risk factors among adults living in Monduli district in Tanzania. The findings will be useful for the provision of tailored interventions focused on community-specific nutritional and behavioral practices. Methods: We conducted a community based cross-sectional study involving a sample of 510 adults aged above 18 years selected using a multistage cluster sampling in the Monduli district of Arusha region, Tanzania. Data were collected by using interviewer-administered questionnaires containing socio-demographic, physical activity, smoking and alcohol consumption. Anthropometry, systolic (SBP) and diastolic blood pressure (DBP) levels were measured. A one-day 24 h diet recall was conducted to evaluate the dietary habits of all participants. Both linear and logistic regression analysis were used to identify the independent predictors for hypertension and blood pressure levels. Results: The prevalence of hypertension in this study was 25.7% (n = 131, 95% CI; 22.1–29.7). The odds of hypertension increased with being male (AOR = 1.75, 95%CI, 1.06–2.88), belonging to the older age group of 30–39 year olds (AOR = 3.3, 95%CI, 1.76–6.38), 40–59 year olds (AOR = 3.34, 95%CI, 1.75–6.37) and ≥ 60 year olds (AOR = 4.2, 95%CI, 2.02–8.87), being overweight or obese (AOR = 3.37, 95%CI, 1.18–9.62), have more hours spent sedentary (AOR = 3.19, 95%CI, 1.61– 6.32), and consumption of fatty foods (AOR = 2.23, 95%CI, 1.27–3.93). The odds for hypertension was significantly reduced among participants who reported higher income (AOR = 0.47, 95% CI, 0.25–0.91), high level of physical activity (AOR = 0.55, 95%CI, 0.31–0.96) and those reported to consume fruit (AOR = 0.37, 95% CI, 0.18–0.77). Consumption of cereals was negatively associated with levels of SBP (β = − 17.4, 95% CI, − 23.8; − 11.0) and DBP (β = − 6.6, 95% CI, − 11.5,-1.79). Conclusion: About one in every four adults living in pastoral communities have been found to have hypertension in this study. Our findings suggest that older age, obesity or overweight, low physical activity, low income, and consumption of fatty foods increase the risk of hypertension among study population. Their diet was dominated by cereals with moderate intake of meat and milk and low fruits. There is a need to promote physical activities and consumption of fruits in the study population in order to fight against hypertension. Further research should be done to confirm the associations.
Prevalence and determinants of overweight and obesity among school children in Morogoro Region, Tanzania.
(Tanzania Journal of Health Research, 2023-01) Muhomba, Elina Stanley; Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Background: Being overweight and obese involve health risks as well as possible consequences for individuals’ and communities’ social and economic well-being. It was previously considered an adult health concern, but it is now seen among children. This study aimed to determine the prevalence and determinants of overweight and obesity among school children in rural and urban areas of Morogoro region, Tanzania. Methods: A cross-sectional study was conducted on a total of 335 parent/caregiver-child pairs, of whom 165 were from Kilosa (rural) and 170 from Morogoro (urban) districts. The main sampling unit was registered primary schools which were stratified according to ownership, whether private or government, and sampled separately. A total of four private and four public schools were sampled, two of each of the categories in each of the locations. Weight and height were measured using standard procedures and Body Mass Index (BMI) was determined. Socio-demographic information was collected using a questionnaire with structured questions. A statistical package for social sciences version 21 was used to analyze data and a regression model was used to explore the determinants of overweight and obesity. Results: The ages of the studied children ranged from 7 to 12 years, while those of the parents/caregivers ranged from 18 to 72 years. About 19% (n=63) of the school children were overweight or obese, while 3.9% (n=13) were underweight. The prevalence of overweight/obesity was higher among private school students than in public schools 36(24.8%) vs 27(14.2%) and more or less similar prevalence’s were observed among rural (17.6%, n=34) and urban (20.0%, n=29) settings. In a multivariate analysis, eating breakfast before going to school is associated with overweight/obesity (AOR 2.23, 95% CI: 1.06-4.68). Other factors associated with overweight/obesity were school type (AOR 1.19, 95% CI: 1.55-2.60), household daily income (AOR 1.88, 95% CI: 1.68-3.15) (AOR 2.89, 95% CI: 1.76-4.11). Conclusion: In conclusion, the prevalence of overweight and obesity among school children was high, while underweight was very low. The prevalence of overweight/obesity was similar in rural and urban children, indicating a nutritional transition. The potential risk factors associated with being overweight or obese were school type, household daily income, provision of breakfast and being given money to buy something to eat at school. Therefore, nutrition and healthy lifestyle education should be integrated into school programs to reduce the risk of developing diseases associated with being overweight or obese.
Prevalence of hyperglycemia in pregnancy and influence of body fat on development of hyperglycemia in pregnancy among pregnant women in urban areas of Arusha region, Tanzania
(BMC Pregnancy and Childbirth, 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania. Methods: A cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-PlusTM using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid- upper arm circumference using a regulated tape, weight using SECATM, blood pressure using a GT-868UF GerathermTM machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire. Results: The participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m 2 (SD ± 5.5). One-third of participants had mid- upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92). Conclusion: The prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.
Prevalence, knowledge and practices on prevention and management of overweight and obesity among adults in Dodoma City, Tanzania
(PLOS ONE, 2024-01-30) Msollo, Safiness Simon; Shausi, Gosbert Lukenku; Mwanri, Akwilina Wendelin
Overweight/obesity is increasing leading to high rates of non-communicable diseases. The study aimed to assess the prevalence, knowledge and practices on prevention and management of overweight/obesity among adults in Dodoma region. Methodology A cross- sectional research was conducted among 313 randomly selected adults aged 25– 65 years. Face to face interviews were conducted to obtain demographic information, knowledge on preventing and managing overweight/obesity using a pre-tested questionnaire. Weight and height were measured following standard procedures and nutrition status was categorized using WHO criteria. Dietary intake was assessed using qualitative 24 hours recall to obtain dietary diversity score. Data was analyzed using the SPSS™ Version 20 to obtain descriptive and inferential statistics. Results About 62.6% (n = 196) of the participants were females. The overall prevalence of overweight/obesity was 59.7% (n = 186) of which 28% (n = 88) were overweight and 31.3% (n = 98) obese. Obesity was three times higher among females (41.8% vs 13.7%) than males. Overweight/obesity was positively associated with female sex (Adjusted OR 2.34; 95%CI: 1.235–4.68; p = 0.001), low knowledge (Adjusted OR 2.15; 95%CI: 1.22–3.81; p = 0.008) and negatively associated with dietary diversity score (Adjusted OR 0. 452; 95%CI: 0.199– 1.87; p = 0.03). About 76% of respondents reported that overweight/obesity is a result of consuming high energy (38.8%; n = 92) and high fat foods (27%; n = 63). More than half of the respondents reported to be insensitive with kind of foods they consume and for those who were sensitive, 64% do so to avoid diseases. Furthermore, 60% control their weight by doing physical exercises while 18% by both physical exercises and diet management. However, about 43% did not know foods exposing individuals to health problems. Conclusion and recommendations High prevalence of overweight/obesity was observed and significantly associated with female sex, low dietary diversity and knowledge on overweight/obesity prevention. This creates a need to improve knowledge on prevention of overweight/obesity.
Risk scores for selective screening for gestational diabetes in Sub Saharan Africa
(Nova Science Publishers, 2020) Mwanri, Akwilina Wendelin; Msollo, Safiness Simon
Gestational diabetes mellitus (GDM) is a threat to maternal and child health. Timely detection and proper management of GDM may reduce the risk for adverse pregnancy outcomes and improve wellbeing of the mother and the child. Prevalence of gestational diabetes mellitus is increasing worldwide with the highest increase noted in middle- and low-income countries. These countries also suffer from limited resources to properly diagnose and manage gestational diabetes mellitus and other pregnancy complications. This chapter reviews the existing selective screening methods and their application in Sub Saharan Africa (SSA). The current guideline recommends universal screening for all pregnant women at any time during pregnancy to ensure that affected women have the opportunity of receiving proper management to prevent adverse outcomes. However, in the countries with limited human, infrastructure and financial resources, this may be a challenge. The use of selective screening reduces the number of unnecessary oral glucose tolerance test hence maximize the use of available resources. Nevertheless, the use of selective screening may still have challenges due to lack of uniformity and variations on results from application of the risk scores. The methods used to identify risk factors vary across the countries depending on the research design, selection of participants, gestational age at screening and diagnosis criteria used. Some risk score models did not perform well because of the challenges in proper identification of risk factors; for example, body mass index (BMI) is known to be one of the important predictors of GDM. However, some studies use pre-gestational BMI by maternal recall of body weight before conception while others used BMI at first clinic visit regardless of gestational age. Furthermore, there are variations in gestational age at screening and diagnosis method used. There is a need to develop country specific checklist for the risk factors which is simple, clear and easy to use at the clinic and for self-identification to enhance self-care.
Simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania
(BMC Pregnancy and Childbirth, 2022) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania. Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus TM and diagnosed in accord- ance with the World Health Organization’s criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured ques- tions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model’s performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science TM . Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumfer- ence ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with ges- tational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96–0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46. Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population.