INFLUENCE OF DIETARY INTAKES, ‘WASH’ AND DIARRHEAL MORBIDITY ON STUNTING AMONG CHILDREN BELOW FIVE YEARS IN NAKURU COUNTY: A CASE STUDY OF KAPTEMBWO AND MILIMANI, KENYA

Daniel Matoke Ayienda, Muthuka J. Kyalo, Job O. Mapesa, Lawrence Mugambi, Eglah J. Kiplagat

Abstract


Stunting is the most prevalent and pervasive form of under nutrition worldwide. In 2019, an estimate of 144 million (21.3%) of children under the age of 5 years are stunted globally. In sub-Saharan Africa, 34% of children fewer than 5 years are stunted and the burden of stunting is most prevalent in the Eastern Africa region with 37% (FAO, 2017). In Kenya, out of a total of 7 million under 5 years, 1.82 million (26%) children are suffering from stunting; out of which 11.4% are severely stunted. Stunting is associated with greater risk of death from infectious diseases in childhood, poorer cognition, poorer educational outcomes and lower adult earnings. The study population was a total of 314 children aged 0-59 months. Data was collected using survey CTO questionnaire. Use of pesticides, hygiene practices and sanitation (human waste disposal), hand washing practices, water sources and means of water treatment were examined and adequately described in relation to EED and stunting. Survey CTO programme was installed in tablets and or smart phones, in which a questionnaire with closed ended questions was programmed and used to collect a no-paper work data. The Survey CTO programmed questionnaire only allowed the researcher to key in a response for one question before moving to the next question. Data was analyzed using SPSS version 22 software. Descriptive analysis was done using SPSS while regression was done using STATA. There was no significant difference in dietary intakes between children in Kaptembwo and Milimani, and that the dietary intakes in both Milimani and Kaptembwo were adequate and balanced. Out of 202 children sampled in Kaptembwo, 40.59% had experienced diarrhea in the last four weeks to data collection while out of 112 children sampled in Milimani, only 17% had experienced diarrhea in the last four weeks. In spite of the same dietary intakes in Kaptembwo and Milimani, stunting is high in Kaptembwo than in Milimani. Out of a total of 314 children sampled, 25% were stunted in Kaptembwo, while only 3.33% were stunted in Milimani. Diarrhea increases loss of dietary nutrients thereby making the nutrients required for growth inadequate. High level of stunting in Kaptembwo is associated with poor environmental conditions (poor sanitation and hygiene) which contribute to diarrhea. Diarrhea could be key contributor to Environmental Enteric Dysfunction (EED), which is too a contributor to stunting. It is recommended that residents of Kaptembwo and Milimani are educated on the importance of good sanitation and hygiene in order to curb diarrhea, which is a contributor to the development of EED. In the same spirit, understand the importance of proper use of pesticides. Experimental research was done in the same area involving the use of biological markers for EED.

Article visualizations:

Hit counter


Keywords


Environmental Enteric Dysfunction (EED), stunting, diarrheal morbidity

Full Text:

PDF

References


Adair, L. S., Guilkey, D. K. (1997). Age-specific determinants of stunting in Filipino children. The journal of nutrition, 127(2), 314-320. doi:10.1093/jn/127.2.314

Alderman, H., John Hoddinott, J., Kinsey, B. (2006). Long term consequences of early childhood malnutrition, Oxford Economic Papers, Volume 58, Issue 3, July 2006, Pages 450–474, doi: 10.1093/oep/gp1008.

Caulfield, L. E., Onis, M. de., Blössner, M., Black, R. E., Under nutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles, The American Journal of Clinical Nutrition, Volume 80, Issue 1, July 2004, Pages 193–198. doi: 10.1093/ajcn/80.1.193.

Checkley, W., Buckley, G., Robert H.Gilman, R. H., Assis, A. M., Guerrant, R. L., Morris, S. S., Molback, K., Valentine-Branth, P., Lanata, C. F., Black, R. E. (2008). The childhood Malnutrition and infection Network, Multi-country analysis of the effects of diarrhea on childhood stunting, International journal of Epidemiology, Volume 37, issue 4, August 2008, p 816-830.

Crane, R. J., Jones K. D., & Berkley, J. A. (2015). Environmental enteric dysfunction: an overview. Food Nutrition Bulletin, 36 (1), S76-S87. doi:10.1177/15648265150361S113

Ettyang, Grace A. K. and Caroline J. Sawe (2016). Factors associated with stunting in children under age 2 in the Cambodia and Kenya 2014 Demographic and Health Surveys. DHS Working Papers No. 126. Rockville, Maryland, USA: ICF International. Available at http://dhsprogram.com/pubs/pdf/WP126/WP126.pdf.

Grantham-McGregor, S. M., Walker, S. P., Chang, S. M., Powell, C. A., Simonoff, E. (2007). Early Childhood Stunting Is Associated with Poor Psychological Functioning in Late Adolescence and Effects Are Reduced by Psychosocial Stimulation, The Journal of Nutrition, Volume 137, Issue 11, November 2007, Pages 2464–2469, doi: 10.1093/jn/137.11.2464.

Kenya National Bureau of Statistics (2019). Kenya population and housing census volume II: Distribution of population by administrative units. National Bureau of Statistics p.241.

Keusch, G. T. P. A., Troncale, F. J., (1972). Sub-Clinical malabsorption in Thailand. II. Intestinal absorption in American military and Peace Corps personnel. American Journal of Clinical Nutrition, 25(10),1067-79.

Keusch, G.T., Rosenberg, I. H., Denno, D. M., Duggan, C., Guerrant, R. L., Lavery, J. V.,Ryan, E. T. (2013). Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low-and middle income countries. Food and nutrition bulletin, 34(3), 357-364. Doi:10.1177/156482651303400308.

Lindenbaum J. (1973). Tropical enteropathy. Gastroenterology, 64(4), 637–652.

Lindenbaum, J. G. C., & Kent, T. H. (1971). Recovery of small intestinal structure and function after residence in the tropics I. Studies in Peace Corps volunteers. Annals of international Medicine, 74(2), 218-22.

Lindenbaum, J. K. T., & Sprinz, H. (1966). Malabsorption and jejunitis in American Peace Corps volunteers in Pakistan. Annals of International Medicine,65(6), 1201-9.

Maluccio, J. A., Hoddinott, J., Behrman, J. R., Martorell, R., Quisumbing, A. R., Stein, A. D., The Impact of Improving Nutrition During Early Childhood on Education among Guatemalan Adults, The Economic Journal, Volume 119, Issue 537, 1 April 2009, Pages 734–763, doi: 10.1111/j.1468-0297.2009.02220.x

Mapesa, J. O., Maxwell, A. L., & Ryan, E. P. (2016). An exposome perspective on environmental enteric dysfunction. Environmental health perspectives, 124(8), 1121. doi:10.1289/ehp.1510459

Mbuya, M. N., & Humphrey, J. H. (2016).Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries. Maternal & Child Nutrition, 12 (Suppl 1), 106–120. doi: 10.1111/mcn.12220

Nshimyiryo, A., Hedt-Gauthier, B., Muaganzwa, C., Kirk, C. M. (2019). Risk factors for stunting among children under five years: a cross-sectional population based study in Rwanda using the 2015 Demographic and Health Survey. BMC Public Health 19, 175. doi: 10: 1186/s12889-019-6504-z

Prendergas A., Kelly. P. (2012). Enteropathies in the developing world: Neglected effects on global health; The American Journal of Tropical Medicine and Hygiene, Volume 86, Issue 5, 1 May 2012, p. 756 – 763. doi:10.4269/ajtmh.2012.11-0743.

Prendergast, A. J., & Humphrey, J. H. (2014). The stunting syndrome in developing countries. Paediatrics and international child health, 34(4), 250–265. doi: 10.1179/2046905514Y.0000000158

Prüss-Üstün, Annette, Wolf, J., Corvalán, Carlos F., Bos, R. & Neira, Maria Purificación. (‎2016)‎. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. World Health Organization. https://apps.who.int/iris/handle/10665/204585.

United Nations’ Children Fund, World Health Organisation, World Bank. Joint Child Malnutrition Estimated-Levels and Trends. Geneva, Switzerland: World Health Organisation, 2017.




DOI: http://dx.doi.org/10.46827/ejfnsm.v1i2.82

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Daniel Matoke Ayienda, Muthuka J. Kyalo, Job O. Mapesa, Lawrence Mugambi, Eglah J. Kiplagat

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2020 - 2023. European Journal of Fitness, Nutrition and Sport Medicine Studies (ISSN 2668-9758, ISSN-l 2668-9758) is a registered trademark of Open Access Publishing Group. All rights reserved.

This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library. All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All the research works published on this journal are meeting the Open Access Publishing requirements and standards formulated by Budapest Open Access Initiative (2002), the Bethesda Statement on Open Access Publishing (2003) and Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities (2003) and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License. Copyrights of the published research works are retained by authors.