Methodology Methods Anthropometric measurements Non-invasive clinical observations

1. Introduction Severe malnutrition is a major underlying cause of morbidity and mortality in pregnant women in sub-Saharan Africa (SSA). Over 50% of pregnant women in SSA are anemic due to deficiencies of iron, vitamin A, folate, and hemoglobinopathies, potentiating the risk for complications during pregnancy. It is estimated that one out of 13 women in rural Uganda will die during childbirth. The Kamuli District of Uganda exhibits widespread food insecurity and subsequent malnutrition, conditions exacerbated by endemic malaria and other pathologies (e.g. HIV/AIDS, parasites, and tuberculosis). Laborious lifestyles and cultural practices such as pica further contribute to deleterious health issues manifested by socioeconomic issues and related food insecurity. Research investigating the impact of food insecurity within rural Uganda is limited and therefore little is known about the dietary practices and obstacles faced by pregnant women in these areas. The study goal was to assess the nutrition and health status of pregnant women residing in rural Kamuli. Objective: Establish a baseline data set of health and nutritional status parameters for pregnant women in rural Kamuli District, Uganda. Assessing the Nutritional Status of Pregnant Women in Rural Kamuli District Uganda Eric Nonnecke1, Benon Musasizi2, Dr. Kevin Schalinske1, and Dr. Manju Reddy1 1Iowa State University, 2Volunteer Efforts for Development Concerns • Methodology • Methods • Anthropometric measurements • Non-invasive clinical observations • Food and health questionnaire • One-week dietary record • Food collection data • Interviews • Invited and informed subjects at three government health centers (Kamuli District) • Obtained consent prior to procedures • Worked closely with each subject throughout process (n=108) • Analysis • Categorize information as it relates to nutrition and health status • Use nutrient algorithms to determine dietary iron intake in addition to other • pertinent dietary makers related to maternal and infant outcomes • Information will strive to provide baseline data for future • studies that aim to improve the livelihoods of these at-risk population groups Figure 2. One week consumption frequency of foods as number of individuals consuming an item per period. Figure 3. Percentage of individuals attending antenatal care visits (2-10 months gestation). Table 1. One day dietary record. Figure 4. Disease incidence and malaria prevalence since onset of pregnancy within population study group. Individuals may have had multiple illnesses and malaria episodes prior and currently at interview. Summary Inadequate micronutrient intake, low BMI, and current morbidities were attributed to infrequent consumption of animal-source protein, inadequate total caloric intake, and reliance on nutrient poor staple crops as a means of subsistence including maize, cassava, and white-flesh sweet potatoes. Subjects had little access to health facilities throughout pregnancy and almost all were unable to obtain regular food, medications, and health care. Acute infection including malaria, bacterial infections, wounds, and dysentery were frequent and amplified underlying chronic health issues (e.g. HIV and tuberculosis). District-wide nutrition and sanitation/health education programs, particularly for young women, are essential to improve the livelihoods of the subject population. Future studies should aim to improve the health and nutritional status of this at-risk population group. Acknowledgements We sincerely thank Dr. David Acker and the Academic Programs of the College of Agriculture and Life Sciences and Council for International Programs for research funding and support. We also gratefully acknowledge the support and assistance Dr. Dorothy Masinde; Center for Sustainable Rural Livelihoods, Dr. David Muzira; Kamuli District Health Center, VEDCO volunteers, The Uganda National Council for Science and Technology for approving the study, and Brandie Martin, Lisa Wasko, and Dr. Gail Nonnecke Iowa State University. Figure 1. Body Mass Index (BMI) per week gestation. Participant mean BMI was compared to references for healthy pregnant Black populations. (N. Ochsenbein-Ko et al. European Journal of Obstetrics & Gynecology and Reproductive Biology 130 (2007) 180–186)