Department of Food Process and Post Harvest Technology

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A strategic approach for African Agricultural Universities experiencing low human capacity to engage in graduate-level training: Lessons from Gulu University in Uganda
(Fifth RUFORUM Biennial Regional Conference, 2016-10) Ogenge, D
The significance of agriculture in driving Africa’s growth and development has greatly gained recognition in the recent past. African universities are expected to play a critical role in African agricultural development process because of their inherent pivotal role in human capital development and agro-technology generation. Many universities in Africa are plagued with low human capacity, a key factor, which has continued to undermine their contribution to economic development in the continent. The most glaring capacity gap is evident at graduate-level training. Therefore, this paper shares lessons based on experience from Gulu University in Uganda on how agricultural universities experiencing human resource capacity gaps can innovatively venture into high quality PhD-level training. The paper describes innovation in curriculum process that led to the development and mounting of a thematic area-based taught PhD program in the Faculty of Agriculture and Environment. This PhD model is considered as an “accommodative strategy” suitable for human resource-constrained universities as it allows for effective use of existing limited human capacity while providing room for expansion within the same curriculum structure concomitant with staff capacity improvement.
Addition of Orange-Fleshed Sweet Potato and Iron-Rich Beans Improves Sensory, Nutritional and Physical Properties But Reduces Microbial Shelf Life of Cassava-Based Pancake (Kabalagala) Designed for Children 2-5 Years Old
(Taylor & Francis, 2021-04-25) Adoko, Melas Cayrol; Olum, Solomon; Elolu, Samuel; Ongeng, Duncan
Innovative use of locally available food resources to develop products of enhanced nutritional quality is one of the strategies believed to alleviate deficiencies of essential micronutrients such as vitamin A and iron are endemic among children 2–5 years in developing countries such as Uganda. New cassava-based pancake (kabalagala) formulae composed of orange-fleshed sweet potato, iron-rich beans, cassava, and sweet banana were developed to target the vitamin A and iron needs of children 2–5 years in Uganda. The new products had better sensory appeal and nutrient density had better physical properties during storage, and were stable to oxidative rancidity but had lower microbial shelf-life compared to the original pancake formula (composed of cassava and sweet banana). Notwithstanding bioavailability constraints, theoretical nutritional computation revealed that serving 100 g (approximately four pieces) of the new products would contribute approximately 99–102% of vitamin A and 110–119% of the iron requirements of the targeted children.
Agroecology influences Salmonella food contamination with high exposure risk among children in Karamoja sub-region: A high diarrhoea prevalent locality in Uganda
(Heliyon, 2022-11-11) Lawrence Okidi; Duncan Ongeng; Patrick Simiyu Muliro; Joseph Wafula Matofari
Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using poly merase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 0.00 to 8.23 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p < 0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33–90%, 40–67%, and 17–88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE, and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.
Agroecology influences Salmonella food contamination with high exposure risk among children in Karamoja sub-region: A high diarrhoea prevalent locality in Uganda
(Heliyon, 2022-11-11) Lawrence Okidia; Duncan Ongeng,; Patrick Simiyu Muliroa; Joseph Wafula Matofaria
Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using polymerase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 0.00 to 8.23 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p <0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33–90%, 40–67%, and 17–88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE,and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.
Agroecology influences Salmonella food contamination with high exposure risk among children in Karamoja sub-region: A high diarrhoea prevalent locality in Uganda
(Heliyon, 2022-11-11) Okidi, Lawrence; Ongeng, Duncan; Muliro, Patrick Simiyu; Matofari, Joseph Wafula
Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using polymerase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 ± 0.00 to 8.23 ± 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p < 0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33–90%, 40–67%, and 17–88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE, and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.
Agroecology influences Salmonella food contamination with high exposure risk among children in Karamoja sub-region: A high diarrhoea prevalent locality in Uganda
(Heliyon, 2022-11-11) Lawrence Okidi; Duncan Ongeng; Patrick Simiyu Muliro; Joseph Wafula Matofari
Uganda is among low-income countries where Salmonella induced diarrhoea still contributes significantly to children under five years (CUF) mortality. Karamoja, a sub-region characterised by three agroecologies (pastoral: PE; agro-pastoral: APE; agricultural: AE), is a geographical location that has consistently experienced a high prevalence of diarrhoea among CUF over the last decade nationally. This study examined whether agroecology influences Salmonella food contamination and exposure risk to CUF. A total of 240 food samples (PE: 78; APE: 73; AE: 89) were examined for Salmonella load using Xylose Lysine Deoxycholate Agar and confirmed using poly merase chain reaction targeting invA gene. Analysis of variance for nested design was used to compare Salmonella counts among food types within and across agroecologies and means were separated using Tukey Honestly Significant Difference test at 5% (p < 0.05). Proportion of foods with Salmonella load exceeding World Health Organisation (WHO) set-limit was expressed in percentage. Exposure risk of CUF was computed by multiplying quantity of food intake by Salmonella load and compared to minimum infectious dose (MID) of the pathogen (3 log CFU) whereas chi-square was used to compare proportions of CUF with exposure above or below MID among agroecologies. Salmonella load ranged from 0.00 0.00 to 8.23 1.12 log CFU but varied by food type and agroecology. Salmonella aggregated load in foods from PE was significantly higher than from APE or AE (p < 0.05). The proportion of Salmonella contaminated foods from PE, APE, and AE was 33–90%, 40–67%, and 17–88%, respectively. Salmonella exposure risks to CUF were similar (p > 0.05) at 96%, 92%, and 91% in PE, APE, and AE, respectively. Sorghum-based foods and leafy vegetables were the predominant high-risk foods. This study has revealed that Salmonella contamination of foods with high exposure risk among CUF in Karamoja sub-region varies with agroecology. Efforts to address food contamination in the sub-region should take into account agroecology.
Community-based nutrition-sensitive approach to address short-term hunger and undernutrition among primary school children in rural areas in a developing country setting:
(BMC Nutrition, 2020) Elolu, Samuel; Ongeng, Duncan
Background: Undernutrition in childhood is an important factor that greatly impedes the achievement of full human potential at adulthood. Despite increased enrolment of pupils in primary schools in developing countries, short-term hunger and undernutrition continue to impact negatively on school attendance, retention and education outcomes in economically disadvantaged rural areas. This study examined the feasibility of a community-based participatory action research approach building capacity of rural women food vendors to use local food resources to produce nutritionally enhanced food products for primary school feeding in rural localities in a developing country setting. Methods: Mixed methods approach incorporating focus group discussions (FGDs) to evaluate parents’ and school administrators’ perceptions of the community-based approach, participatory experimental improvement of nutritional quality of an energy-based cassava product (gari) involving community women food vendors, and cross-sectional acceptability assessment of improved products among rural primary school children. Qualitative content analysis, one-way analysis of variance and correlation analysis was used to analyse FGD data, compare nutritional profile and consumer sensory profile of different products, and examine associations between sensory attributes and acceptability of the products, respectively. Results: The approach of using local food resources to produce nutritious products targeting school feeding was strongly recognised by parents, school administrators, teachers and small scale rural women food vendors as an adoptable nutritionsensitive means of addressing short-term hunger among primary school children in rural settings. The action research resulted in a highly accepted nutritionally enhanced product (consisting of cassava, soy and silver fish) exhibiting superior nutritional properties (23.29% protein, 90.5 g/100 g calcium, 4.5 g/100 g zinc, 11.6 g/100 g iron, 40.40 g/100 g phosphorus, 61.57 μg/100 g vitamin A) compared to the original energy-dominated cassava product (2.18% Protein, 55.6 g/100 g calcium, 1.2 g/100 g zinc, 4.4 g/100 g iron, 6.6 g/100 g phosphorus, 11.23 μg/100 g vitamin A) (p < 0.05). Nutritional computation revealed that serving 120 g of the new product would suffice to meet 30% of the recommended dietary allowance for essential nutrients that children should receive from school meals. Conclusion: Community-level nutrition-sensitive innovation using local foods resources offers the opportunity for rural women food vendors to contribute to addressing short-term hunger and undernutrition challenges in primary schools in economically-disadvantaged localities in developing countries.
Development of micronutrient dense composite flour for routine enrichment of complementary foods for children 6–24 months old in Acholi sub‑region of Uganda
(Discover Food, 2023-12-11) Ugada, Aliet Mmbone; Okidi, Lawrence; Ongeng, Duncan
Background The use of local foods has been widely recognized as a sustainable strategy to address micronutrient deficiencies among resource-constrained households in rural areas in developing countries. Acholi sub-region of Uganda has recently recorded a high prevalence of micronutrient deficiencies due to inadequate iron, zinc, and calcium contents in complementary foods. Thus the sub-region was used as a case study to examine the potential of amaranth grain silverfish-iron rich beans micronutrient dense composite flour in improving nutritional quality of complementary foods. Design Microsoft Excel was used to derive ingredient combinations based on the micronutrient requirements. Laboratory analyses were used to determine (1) nutritional quality; (2) functional properties and; (3) storage stability of the micronutrient-dense composite flour. Data was analysed using a one-sample t-test and analysis of variance by Statistical Package for Social Sciences (SPSS) version 25. Results The micronutrient-dense composite flour contained 19 mg/100 g, 13 mg/100 g, and 354 mg/100 g of iron, zinc, and calcium, respectively. The cost (0.037–0.058 USD) of the micronutrient-dense composite flour required to meet the RDA for iron and zinc among children 6–24 months old was found lower than the cost (4.81 USD) of a sachet of standard micronutrient powder equivalent to RDA. The product exhibited low bulk density (0.68 g/l), high water solubility index (25.56–29.16%), and short reconstitution time (40.00–45.00 s), and remained safe during the entire 70 days of storage. Theoretically, daily enrichment of complementary foods for children 6–11 and 12–24 months old with 58 and 37 g of the composite, respectively would contribute 100% of the recommended dietary allowance for iron and zinc and 50% for calcium. Conclusion The developed micronutrient-dense composite flour has the potential to improve the micronutrient quality of complementary foods. A concerted effort is required to promote its use as a strategy to address micronutrient deficiencies among children 6–24 months in resource-constrained settings.
Dietary intake and socio-economic predictors of inadequate energy and nutrient intake among women of childbearing age in Karamoja sub-region of Uganda
(Journal of Health, Population and Nutrition, 2023) Muggaga, Christopher; Okello‑Uma, Ipolto; Natigo, Archileo Kaaya; Taylor, David; Ongeng, Duncan; Basil, Mugonola
Karamoja sub-region is the most food insecure part of Eastern Africa. The poor status of food security in the sub-region is reflected in the high rate of undernutrition among women of childbearing age (WCBA) and children under 5 years (CUFY). The sub-region is unique in Uganda in terms of cultural diversity, agro-ecology and rainfall pattern and agricultural practices. However, the influence of these unique characteristics on dietary intake of WCBA in the sub-region is less understood. Therefore, this study examined dietary intake and socio-economic predictors of inadequate energy and nutrient intake among WCBA in Karamoja sub-region.
Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study
(BMC Pediatrics, 2022-05-30) Okidi, Lawrence; Ongeng, Duncan; Muliro, Patrick Simiyu; Matofari, Joseph Wafula
Background Undernutrition accounts for nearly half of under-five child mortality in developing countries where household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture in those countries, limited information exists on whether undernutrition in children under five varies with agro-ecological location. Methods Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area, and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral, and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The level of statistical significance was set at p ≤ 0.05. Results The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001) increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies. Conclusion This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such locations should be agroecology specific.
Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study
(BMC Pediatrics, 2022-05-30) Okidi, Lawrence; Ongeng, Duncan; Muliro, Patrick Simiyu; Matofari, Joseph Wafula
Background: Undernutrition accounts for nearly half of under-five child mortality in developing countries where household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture in those countries, limited information exists on whether undernutrition in children under five varies with agro ecological location. Methods: Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area, and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral, and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The level of statistical significance was set at p ≤ 0.05. Results: The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001) increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies Conclusion: This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such locations should be agroecology specific.
Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study
(BMC Pediatrics, 2022-05-30) Okidi, Lawrence; Ongeng, Duncan; Muliro, Patrick Simiyu; Matofari, Joseph Wafula
Background Undernutrition accounts for nearly half of under-five child mortality in developing countries where household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture in those countries, limited information exists on whether undernutrition in children under five varies with agro-ecological location. Methods Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area, and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral, and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The level of statistical significance was set at p ≤ 0.05. Results The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001) increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies. Conclusion This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such locations should be agroecology specific.
The effect of traditional malting technology practiced by an ethnic community in northern Uganda on in-vitro nutrient bioavailability and consumer sensory preference for locally formulated complementary food formulae
(Food Science and Nutrition, 2018-10) Alowo, Docus; Muggaga, Christopher; Ongeng, Duncan
The occurrence of anti-nutritional constituents in plants is an important factor that negatively affects bioavailability of nutrients and effectiveness of plant-based foods in complementary feeding in rural areas in developing countries. However, proven methods that improve bioavailability of nutrients and tailored for application in processing complementary foods among rural communities are largely lacking. This study examined the efficacy of a traditional malting technology practiced by the Acholi ethnic community of northern Uganda to improve protein digestibility and bioavailability of iron and zinc from millet–sesame–soy composite containing 200, 300, and 550 kcal meant for complementary feeding of children aged 6–8, 9–12, and 13–23 years old, respectively. The technology involves washing and soaking of ingredients for 12 hr; malting ingredients individually for 48 hr with water changed after every 6 hr; and sun-drying malted ingredients for 72 hr. Results showed that the level of anti-nutritional factors significantly reduced (p ≤ 0.05) in all the composite formulae except the content of total phenolics in 200, tannins in 300 and 550 kcal, composite formula, respectively. In vitro protein digestibility significantly improved (p ≤ 0.05) in all the composite formulae except in the 200 kcal formula. Iron bioavailability significantly increased (p ≤ 0.05) in all the composite formulae except in the 550 kcal energy category. Improvement in zinc bioavailability was only observed in the 300 kcal formula. However, there were significant reductions (p ≤ 0.05) in the level of caregiver preferences for sensory properties and overall acceptability of the composites. These results demonstrate that the traditional malting technology has potential to improve nutrient bioavailability in plant-based foods but requires improvement in order to increase its efficacy and mitigate negative effects on sensory appeal.
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
(The Lancet Journal, 2024-03-11) Okidi, Lawrence; GBD 2021 Demographics Collaborators
Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic.
Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
(Elsevier, 2024-10) Okidi, Lawrence; GBD 2021 Stroke Risk Factor Collaborators
Background Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden.
Household food security, child dietary diversity and coping strategies among rural households. The case of Kole District in northern Uganda
(Elsevier, 2023) Elolu, Samuel; Agako, Alod; Okello, Daniel Micheal
Household food security, feeding practices, dietary diversity and coping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers of children 0-36 months of age in Kole district of northern Uganda, this study examined the household food security status, child dietary diversity and household coping strategies. The study revealed that a slight majority of the households (55%) were food secure although with a low level of child dietary diversity experienced (68.1% for children 6-23 months age group and 55.3% for 24-36 months age group). We found that starch-based foods derived from cereals, roots and tubers were the most predominantly used food group in child feeding (82%), with limited consumption of other essential food groups, notably fruits, vegetables, meats and dairy products (18% combined). Additionally, only 57% of children 0 to 6 months old were receiving exclusive breastfeeding, and the introduction of complementary foods is often delayed and not well planned for those above 6 months of age. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of meals taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). It was observed that household food security is a strong determinant of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. Furthermore, nutritional education, household size and livelihood diversity play a significant role in determining household food security status, child dietary diversity and coping with food insecurity within rural households. In conclusion, addressing household food security, and coping strategies can play an important role in improving child feeding practices and dietary diversity in rural communities.
Impact of Community Action Research Project (CARP+1) on the livelihoods of smallholder pig farmers in northern Uganda
(RUFORUM Working Document Series, 2021-12-06) Ndyomugyenyi, E. K.; Kidega, K.
Pig production in Uganda is largely constrained by high feed costs, poor breeds, foul smell in pig houses, and the fact that markets are not reliable for live pigs and products. To address the constraints, the Community Action Research Project (CARP+1) introduced user-friendly interventions to smallholder pig farmers in northern Uganda. This study aimed to establish the impact of the CARP+1 interventions on pig production and livelihoods of the smallholder pig farmers. Data were collected from 75 purposively selected farmers out of the 109 who kept pigs at the start of the CARP+1. Structured questionnaires, observations and interviews were used to collect the data. The number of farmers who were not keeping pigs decreased by 85.8% as a result of CARP+1 intervention. Farmers who kept over 16 pigs increased (P≤0.05) from 0.00% to 3% after the intervention. Farmers who earned over Ugx 1,600,000 (annually) from pig production increased (P≤0.05) from 3.3% to 13.2% after the intervention. As a result of the CARP+1 intervention, pig farmers were able to pay school fees for their children (63.3%) and purchase foodstuffs for their families (56.7%). Pig farmers (96.7%) were able to use the knowledge they got from the CARP+1 to improve the housing condition of pigs using deep floor on which indigenous microorganism liquid was applied, formulate cheap feed from local feedstuffs and disease control. In conclusion, the CARP+1 intervention significantly improved pig production and livelihoods of smallholder pig farmers in northern Uganda.
Improving nutrition-sensitive value chains of African indigenous vegetables: current trends in postharvest management and processing
(Frontiers sustainable food systems, 202-06-15) Elolu, Samuel; Byarugaba, Rachel; Opiyo, Arnold Mathew; Nakimbugwe, Dorothy; Mithöfer, Dagmar; Huyskens-Keil, Susanne
The value chains of African indigenous vegetables (AIVs) are highly constrained by high postharvest losses (up to 50%) along the chain, largely occasioned by poor postharvest management and a lack of optimized processing technologies. The technologies and practices are key technical aspects that can transform the capacity of the chain by enhancing the overall value generated from the system. AIVs have recently experienced an increase in demand due to their high nutritional value and the opportunity they present to enhance rural incomes, since they are predominantly produced by smallholder farmers in rural and peri-urban areas. This implies that they can positively contribute to increased availability and hence supply of nutritious food within local food systems. Furthermore, the fact that half of the economic value of AIVs is potentially lost due to inappropriate postharvest management and inadequate processing demonstrates the potential that related interventions and transformations could have in enhancing and preserving value along AIV value chains. Currently, the approaches applied to reduce food waste, preserve nutritional quality, and add value to AIVs are largely traditional in nature. They require upgrading and need to be aligned toward achieving a nutrition-sensitive value chain. By looking at these as value creation processes, this mini-review examines the current postharvest management practices, highlights relevant new and innovative technologies and related challenges, and suggests potential options to improve the benefits for AIV value chain actors and thus contribute to a sustainable transformation of nutrition-sensitive food systems.
In vitro bioavailability-based assessment of the contribution of wild fruits and vegetables to household dietary iron requirements among rural households in a developing country setting: The case of Acholi Sub region of Uganda
(Wiley, 2020-10-14) Tuyizere, Jean Damascene; Okidi, Lawrence; Elolu, Samuel; Ongeng, Duncan
Wild fruits and vegetables (WFV) are believed to contain substantial quantities of micronutrients and are commonly consumed in rural areas of developing countries endowed with natural vegetation. Previous studies that provided evidence on the contribution of WFV to household micronutrient intake in a developing country setting did not consider the effect of anti-nutritional factors. Therefore, applying the in vitro bioavailability assessment technique and using the Acholi sub-region of Uganda a case area, this study examined the contribution of commonly consumed WFV to the pooled annual household dietary requirement for iron. Laboratory analysis showed that the concentration of antinutrients varied with plant species but the pool was dominated by phytate (10.5–150 mg/100 g) and phenolic substances (38.6–41.7 mg GAE/g). In vitro, iron bioavailability varied with plant species and was quantitatively higher in vegetables than fruits by 27% although the total concentration of the micronutrient was higher in fruits than vegetables by 142%. Nutritional computation, taking into account, household composition, and physiological status revealed that consumption of WFV resulted in a median contribution of 1.8% (a minimum of 0.02 and a maximum of 34.7%) to the pooled annual household dietary iron requirements on the basis of bioavailable iron fraction. These results demonstrate that WFV contributes meagrely to household iron needs but may serve other dietary and non-nutrient health purposes.
The influence of sugarcane growing by smallholder farmers on household livelihood, food security, and nutrition status of children below five years in mid-western Uganda
(Journal of Agriculture and Food Research, 2023-11-23) Oyet, Sunday Mark; Muggaga, Christopher; Okello-Uma, Ipolto; Mbabazi, Kaahwa Robert
The current study aimed at determining the influence of sugarcane production on livelihoods, food security and nutrition status. A cross-sectional study was carried out among 350 smallholder farmers in mid-western Uganda. Food security was assessed by Household Food Insecurity Access Scale (HFIAS) while household livelihood and nutrition status of children below five (5) years were assessed by a semi-structured questionnaire and anthropometry respectively. Results showed that sugarcane growing households (SCG) cultivated more acreage of food, owned more assets, earned more income than the non-sugarcane growing households (NSCG). Ownership of motorcycles was higher (p < 0.05) among SCG than NSCG. Households reported anxiety and uncertainty of having food in the previous four weeks (SCG 38%; NSCG 55.2%); had insufficient food quality (SCG 56.8%; NSCG 70.7%); and had insufficient food quantity (SCG 41.7%; NSCG 49.2%). SCG were more food secure (32.3%) than the NSCG (20.8%) (p < 0.05) with a corresponding mean HFIAS of 6.56 ± 6.69 and 8.41 ± 6.41, respectively. Stunting among children below five years among NSCG was higher (34.6%) than in SCG (21.3%). Among SCG, 7.3% and 5.2% of children were underweight and wasted while 6.06% and 2.7% were underweight and wasted from NSCG. This demonstrated that sugarcane growing had better livelihood outcomes, positively impacted on asset ownership and food security but mixed effect on nutrition indicators among children in sugarcane growing and non-sugarcane growing households. It is recommended that government and development agencies diversify livelihoods among the NSCG and reinforce the existing livelihoods among SCG; provide nutrition education to both SCG and NSCG for improved food security and nutrition outcomes. Authors suggest further studies using a mixed approach to assess the levels of household nutrient intake in sugarcane growing areas.

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