1
|
Nakaggwa F, Kimuli D, Namuwenge N, Nsubuga RN, Nayebare H, Kaboine L, Baseka I, Kasule K, Nyakwezi S, Sevume S, Mubiru N, Amuron B, Bukenya D. Prevalence, patterns, and determinants of breastfeeding cessation among mothers of children under 24 months in Uganda. BMC Public Health 2024; 24:1512. [PMID: 38840094 PMCID: PMC11155002 DOI: 10.1186/s12889-024-19028-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/31/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Breastfeeding duration is a critical component of infant and child nutrition, providing immediate and long-term benefits to both children and their mothers. This study uses data from the lot quality assurance sampling (LQAS) survey to examine the prevalence, patterns, and determinants of breastfeeding cessation in Uganda. METHODS This study was a secondary analysis of data collected by the cross-sectional LQAS surveys in 2021 and 2022 covering 77 districts in Uganda. The LQAS survey methodology employs a systematic sampling approach to assess whether predefined quality standards are met within specific subgroups of a population. The study employed spatial analysis, bivariate analysis and logistic regression, both with and without clustering, to explore associations between independent variables and breastfeeding cessation. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated. Statistical significance was set at 5%. RESULTS Overall, the study analysed 26,377 records of mothers with children under 24 months old. The mothers' mean age was 27.9 years while that of their children was 11.0 months. While the general breastfeeding cessation rate was 17.7%, cessation was highest (49.7%) among mothers of children 18-23 months. Factors associated with increased odds of breastfeeding cessation included older child's age, older mother's age, using modern family planning, being pregnant and having an unknown pregnancy status. Lower odds of breastfeeding cessation were observed among mothers who; were married, lived in larger households, lived in rural residences, whose children received vitamin A supplementation and among all other regions compared to Kampala. CONCLUSION One in five mothers cessed breastfeeding before their child reached 2 years, with a significant increase in cessation odds among mothers of older children. These findings underscore the importance of interventions to promote breastfeeding continuation and adequate nutrition for non-breastfed infants, particularly in regions with high cessation rates.
Collapse
Affiliation(s)
- Florence Nakaggwa
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda.
| | - Derrick Kimuli
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Norah Namuwenge
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Rebecca N Nsubuga
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Hellen Nayebare
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Louis Kaboine
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Immaculate Baseka
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Kenneth Kasule
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Sheila Nyakwezi
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Solome Sevume
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Norbert Mubiru
- The United States Agency for International Development Uganda, US Mission Compound-South Wing, Kampala, Uganda
| | - Barbara Amuron
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| | - Daraus Bukenya
- United States Agency for International Development, Strategic Information Technical Support (SITES) Activity, Social & Scientific Systems, Inc, DLH Holdings company, Kampala, Uganda
| |
Collapse
|
2
|
Gafane-Matemane LF, Craig A, Kruger R, Alaofin OS, Ware LJ, Jones ESW, Kengne AP. Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities. J Hum Hypertens 2024:10.1038/s41371-024-00913-6. [PMID: 38698111 DOI: 10.1038/s41371-024-00913-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Abstract
Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017-2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus . To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.
Collapse
Affiliation(s)
- Lebo F Gafane-Matemane
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa.
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa.
| | - Ashleigh Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Soweto, 1864, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa
- SAMRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, South Africa
| | - Omotayo S Alaofin
- Hypertension in Africa Research Team, North-West University, Potchefstroom, 2520, South Africa
| | - Lisa J Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Soweto, 1864, South Africa
| | - Erika S W Jones
- Division of Nephrology and Hypertension, Groote Schuur Hospital and Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Francie Van Zijl Dr, Parow Valley, Cape Town, 7501, South Africa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University, Mthatha, South Africa
| |
Collapse
|
3
|
Saraswati CM, Judge MA, Weeda LJZ, Bassat Q, Prata N, Le Souëf PN, Bradshaw CJA. Net benefit of smaller human populations to environmental integrity and individual health and wellbeing. Front Public Health 2024; 12:1339933. [PMID: 38504675 PMCID: PMC10949988 DOI: 10.3389/fpubh.2024.1339933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The global human population is still growing such that our collective enterprise is driving environmental catastrophe. Despite a decline in average population growth rate, we are still experiencing the highest annual increase of global human population size in the history of our species-averaging an additional 84 million people per year since 1990. No review to date has accumulated the available evidence describing the associations between increasing population and environmental decline, nor solutions for mitigating the problems arising. Methods We summarize the available evidence of the relationships between human population size and growth and environmental integrity, human prosperity and wellbeing, and climate change. We used PubMed, Google Scholar, and Web of Science to identify all relevant peer-reviewed and gray-literature sources examining the consequences of human population size and growth on the biosphere. We reviewed papers describing and quantifying the risks associated with population growth, especially relating to climate change. Results These risks are global in scale, such as greenhouse-gas emissions, climate disruption, pollution, loss of biodiversity, and spread of disease-all potentially catastrophic for human standards of living, health, and general wellbeing. The trends increasing the risks of global population growth are country development, demographics, maternal education, access to family planning, and child and maternal health. Conclusion Support for nations still going through a demographic transition is required to ensure progress occurs within planetary boundaries and promotes equity and human rights. Ensuring the wellbeing for all under this aim itself will lower population growth and further promote environmental sustainability.
Collapse
Affiliation(s)
| | - Melinda A. Judge
- Telethon Kids Institute, Perth, WA, Australia
- School of Mathematics and Statistics, University of Western Australia, Nedlands, WA, Australia
| | - Lewis J. Z. Weeda
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Ndola Prata
- Bixby Center for Population Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Peter N. Le Souëf
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Corey J. A. Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, Wollongong, NSW, Australia
| |
Collapse
|
4
|
Sekoai PT, Roets-Dlamini Y, O’Brien F, Ramchuran S, Chunilall V. Valorization of Food Waste into Single-Cell Protein: An Innovative Technological Strategy for Sustainable Protein Production. Microorganisms 2024; 12:166. [PMID: 38257991 PMCID: PMC10819637 DOI: 10.3390/microorganisms12010166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
The rapidly increasing population and climate change pose a great threat to our current food systems. Moreover, the high usage of animal-based and plant-based protein has its drawbacks, as these nutritional sources require many hectares of land and water, are affected by seasonal variations, are costly, and contribute to environmental pollution. Single-cell proteins (SCPs) are gaining a lot of research interest due to their remarkable properties, such as their high protein content that is comparable with other protein sources; low requirements for land and water; low carbon footprint; and short production period. This review explores the use of food waste as a sustainable feedstock for the advancement of SCP processes. It discusses SCP studies that exploit food waste as a substrate, alongside the biocatalysts (bacteria, fungi, yeast, and microalgae) that are used. The operational setpoint conditions governing SCP yields and SCP fermentation routes are elucidated as well. This review also demonstrates how the biorefinery concept is implemented in the literature to improve the economic potential of "waste-to-protein" innovations, as this leads to the establishment of multiproduct value chains. A short section that discusses the South African SCP scenario is also included. The technical and economic hurdles facing second-generation SCP processes are also discussed, together with future perspectives. Therefore, SCP technologies could play a crucial role in the acceleration of a "sustainable protein market", and in tackling the global hunger crisis.
Collapse
Affiliation(s)
- Patrick T. Sekoai
- Biorefinery Industry Development Facility, Council for Scientific and Industrial Research, Durban 4041, South Africa;
| | - Yrielle Roets-Dlamini
- Bioprocessing Group, Council for Scientific and Industrial Research, Pretoria 0001, South Africa; (Y.R.-D.); (F.O.); (S.R.)
| | - Frances O’Brien
- Bioprocessing Group, Council for Scientific and Industrial Research, Pretoria 0001, South Africa; (Y.R.-D.); (F.O.); (S.R.)
| | - Santosh Ramchuran
- Bioprocessing Group, Council for Scientific and Industrial Research, Pretoria 0001, South Africa; (Y.R.-D.); (F.O.); (S.R.)
- School of Life Science, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Viren Chunilall
- Biorefinery Industry Development Facility, Council for Scientific and Industrial Research, Durban 4041, South Africa;
- Discipline of Chemical Engineering, University of KwaZulu-Natal, Durban 4041, South Africa
| |
Collapse
|
5
|
Mekonen EG, Zegeye AF, Workneh BS. Complementary feeding practices and associated factors among mothers of children aged 6 to 23 months in Sub-saharan African countries: a multilevel analysis of the recent demographic and health survey. BMC Public Health 2024; 24:115. [PMID: 38191351 PMCID: PMC10775555 DOI: 10.1186/s12889-023-17629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/31/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries. METHODS A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices. RESULTS The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75-13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices. CONCLUSION The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.
Collapse
Affiliation(s)
- Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|