BACKGROUND AND OBJECTIVES: Malnutrition is a significant contributor to child morbidity and mortality globally. Egg consumption has been associated with improved child nutrition yet is rare in rural, resource-poor settings. We test the effects of a culturally tailored behavior change intervention to increase child egg consumption. METHODS: A 3-arm cluster randomized controlled trial was conducted in rural Burkina Faso with 260 mother-child dyads. Children aged 4 to 17 months from 18 villages were included; those with reported history of malnutrition or egg allergy were excluded. Each child in the full intervention arm received 4 chickens, and mothers received the 10-month behavior change package. Participants in the partial intervention arm received only the behavior change package. RESULTS: In this analysis of 250 children, the full (β = 4.3; P = 6.6 × 10−12) and the partial (β = 1.0; P = .02) interventions significantly increased egg consumption. The full intervention also significantly increased poultry production (β = 11.6; 95% confidence interval 8.3–15; P = 1.1 × 10−5) and women’s decision-making about eggs (β = .66; P = .02), and significantly decreased wasting (β = .58; P = .03) and underweight (β = .47; P = .02). CONCLUSIONS: The culturally tailored behavior change package significantly increased child egg consumption. When coupled with the gift of chickens, the behavior change intervention yielded a greater increase in egg consumption and significantly reduced wasting and underweight. Behavior change strategies to increase egg consumption should be considered among nutrition and health programs in resource-poor settings where poultry is available.
Introduction: Complementary feeding presents a challenge for very young children in Ethiopia as these foods are generally thin cereals providing little protein and micronutrients. We tested whether an egg-a-day and eggshell powder (ESP) providing calcium (Ca) will improve nutritional status of young children in a 6-month randomized controlled cluster trial in Southern Ethiopia. Methods: Study sites were randomly selected kebeles (villages) and assigned to Intervention and Control groups. All eligible children 6-12 months were enrolled. Each child in Intervention kebeles received a gift of two egg laying chickens (n=122); families received education on poultry production and consumption of egg. ESP (500 mg Ca) was given to children at ≥12 mo. The Control group (n=128) had standard nutrition education. Baseline and endline outcome measures included knowledge, attitude, and practice (KAP) of caregivers on the feeding of egg and ESP, anthropometry, child dietary intake frequencies, egg sensitivities, hemoglobin, and morbidity symptoms. Results: Egg and ESP consumption in Intervention children averaged 17 days/month compared to < 1 in Controls. KAP of mothers improved only in the intervention group (p<0.001). No true egg allergy occurred, however, 7.5% of Intervention children were sensitive to eggs. Linear regression analysis showed the egg+ESP intervention increased weight-forage z-score by 0.24 (95% CI, 0.11-0.37) and reduced underweight (RR, 0.35; 95% CI, 0.16-0.74). Stunting prevalence increased in both groups, but by 28 % less in the treatment group (RR, 0.72; 95% CI, 0.53-0.98) compared with control. Mean hemoglobin increased and anemia decreased in both groups, however, much greater anemia reduction [52% (RR, 0.48; 95% CI, 0.24-0.96)] was seen in the treatment group. Conclusion: Promotion of egg and ESP consumption with poultry intervention significantly improved the nutritional status of young children, demonstrating the potential of an integrated approach to contribute to the country"s target to reduce malnutrition.
Animal source foods such as eggs are often lacking in complementary foods in Ethiopia, a country with a high rate of malnutrition in under 5-year-old children. It is recommended that young children receive an egg a day, but rural households often cannot afford them or do not have experience raising chickens. The aim of this study was to conduct a poultry intervention, providing two chickens to households with a young child, stipulating that the child was the owner, and required an egg a day. This randomized, controlled, community trial was conducted in southern Ethiopia with children 6-12 mo living in selected kebeles. Chickens were gifted to families who guaranteed that eggs would be fed to the child in the Intervention, along with education on poultry production and promotion of eggs for children. Eggshell powder (ESP) was encouraged for use as a calcium supplement by children ≥ 1 y. Control kebeles continued with existing nutrition education for the 6-month trial. Baseline and end line outcome measures included child consumption of eggs, ESP, and poultry production. Other outcome measures will be reported elsewhere. Egg consumption by children was significantly improved only in the intervention group from 0.8 to 17 eggs/month (p < 0.001). ESP consumption got community acceptance with an average consumption of a child in the intervention group for 17 days/month (p < 0.001). Poultry production increased in the Intervention communities even when child-owned chickens were excluded from analysis (from 138 to 251 chickens) while in the Control communities, the number of chickens decreased (from 219 to 101). Cage construction improved in the Intervention communities, however, losses of chickens occurred. A 6-month poultry intervention that emphasized child ownership and provided education for poultry and nutrition education resulted in families increasing livestock numbers, and children eating on average more than half an egg a day.
The thermal and exercise tolerances of 165 Sudanese cane cutters were measured in the laboratory and related to work performance and productivity in the cane fields. The results showed that the amount of cane cut per minute in the field was significantly correlated with changes in body weight (r = +0-53) during the third hour of work, aerobic energy expenditure (r = + 0-43), and cardiac frequency during work. These variables in turn were associated with predicted maximal power output (VO2 max) measured in the laboratory. The average energy expenditure during cane cutting was 1-66 +/- 0-33 1/min-1 (34-9 kJ/min-1) which represents approximately 60% of the workers predicted VO2 max. This rate of energy expenditure was sustained in the cane fields for at least three hours without significant pauses for rest. The sweat losses measured in 32 cane cutters during the two and three hours of work averaged 637 +/- 221 and 770 +/- 282 g/h-1 respectively, while the mean urine temperature immediately on cessation of effort was 37-74 +/- 0-46 degrees C. Despite the additional environmental heat load of the tropics, it would seem that cane cutters performing a self-paced task demanding heavy physical effort, are able to sustain work levels well in excess of those recommended for most European factory workers without obvious signs of fatigue or heat stress.
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