Anselimo Makokha - Academia.edu (original) (raw)

Papers by Anselimo Makokha

<jats:p>Yoghurt is a popular fermented milk product across the globe. As consumers become m... more <jats:p>Yoghurt is a popular fermented milk product across the globe. As consumers become more health conscious, there has been rising interest in probiotic yoghurts, fermented with bacteria that can promote human health, as well as yoghurts containing fruit pieces, juice or pulp, which increase the levels of phytochemicals, dietary fibre and some vitamins in the product. Generally, the fruit products are added only up to about 20%. Here we investigated the physicochemical, sensory and microbial properties of analogous fermented products containing milk, but consisting mainly of papaya fruit pulp. Formulations were made at different ratios ranging from 50-100% papaya pulp. Yoghurt (with 0% papaya) was made to serve as the control. Conditions for pasteurization prior to fermentation were optimized for the control of yeasts and molds. The products were fermented with a probiotic culture consisting of Streptococcus thermophilus + Lactobacillus acidophilus + Bifidobacterium spp. Sensory analysis on a 9-point hedonic scale revealed an increase in acceptability of the various attributes with increase in pulp. Formulations containing 80% to 100% papaya fruit were found to be most liked and of comparable quality to the control, having scores of ≥ 7 (ranging from moderately liked to liked very much)) in colour, taste, texture and overall acceptability. Compared to the control, these formulations were found to contain more ascorbic acid, riboflavin, niacin, folic acid, dietary fiber and carbohydrates. The control was however higher in thiamine, protein and fat levels. The products were stable under refrigerated storage (4 ⁰C) for 3 weeks. In conclusion, we found that papaya pulp fermented with a probiotic starter culture, and containing up to 20% milk had good sensory acceptability. The health benefits of such products are worthy of further investigations.</jats:p>

Journal of Food Processing and Preservation, Aug 30, 2016

Cooking quality of common beans greatly influences acceptability. The objective of this study was... more Cooking quality of common beans greatly influences acceptability. The objective of this study was to quantify the effect of bean type, storage time, temperature and relative humidity (RH) on the cooking time of four bean types grown in Kenya. Beans were stored under different temperature (25, 35 and 45C) and RH (75 and 83%). After sampling, they were pre-soaked or not and cooked to generate cooking curves which were subjected to nonlinear regression. Significance of the different variables was evaluated using mixed model regression. Higher storage temperatures (35 and 45C), higher RH (83%) and extended time significantly increased lag phase and cooking time. Soaking pretreatments reduced cooking time. Canadian wonder and Pinto beans took long thus hard-to-cook while Rose coco and Red haricot took short cooking time, thus, easy-to-cook. This work demonstrated the critical nature of bean type, storage and pretreatment conditions in influencing bean cooking quality. PRACTICAL APPLICATIONS The hard-to-cook (HTC) problem in common beans is one of the main problems leading to low consumption of beans. This manuscript provides information on the easy to cook and HTC bean varieties grown in Kenya. The roles of storage temperature and relative humidity on predisposing beans to the HTC problem is discussed including the optimal storage conditions. Finally, the effect of pretreatment conditions and cooking on overall cooking time is highlighted. Soaking in distilled water and Na 2 CO 3 significantly reduced the cooking time of the beans. It is hoped that this information can be translated to practical guidelines for bean breeders, stockists, processors and consumers.

African Crop Science Conference Proceedings, 2005

Vitamin A deficiency (VAD) is a big public health problem in East Africa. It contributes to incre... more Vitamin A deficiency (VAD) is a big public health problem in East Africa. It contributes to increased child mortality by lowering immunity, particularly among children. It also causes night blindness and xerophthalmia. Efforts to reduce the condition through food supplementation and fortification with vitamin A have been largely unsuccessful. The objective of this paper is to review current efforts to alleviateVAD through increased production and consumption of cassava and sweet potatoes with high provitamin A carotenoids. With the support of the CGIAR and the National Agriculture Research Systems in East Africa, there has been increased production of orange fleshed sweet potatoes, with high provitamin A carotenoids. Such cultivars have been obtained mainly by traditional selection and breeding methods, and by biofortification. Such cultivars have already been widely distributed to farmers in the region, and are contributing to the alleviation of VAD. Similarly, there are efforts to introduce and disseminate yellow/ orange cultivars of cassava with high provitamin A carotenoids in the region. Among the constraints that these efforts face include problems with acceptability of the high carotenoid cultivars, since they have different appearance, flavour and texture from most of the low carotenoid traditional varieties. Further, the availability of vitamin A from these plant sources is lower than that from animal sources. There are also losses of the carotenoids during handling, processing and cooking of the potatoes and cassava. However, overall, the introduction of the high carotenoid sweet potato varieties have had a significant impact in reducing the incidence of VAD in the region. The impact is expected to increase as the dissemination of these cultivars, and those of high carotenoid cassava varieties increase. It is recommended that the aspects of nutrition education and social marketing be enhanced to further increase the production, dissemination and consumption of the high carotenoid cultivars of sweet potatoes and cassava in the East Africa region.

Background Type 2 diabetes mellitus (T2D), is a life-threatening condition of global public healt... more Background Type 2 diabetes mellitus (T2D), is a life-threatening condition of global public health concern. It worsens in the presence of the metabolic syndrome (MetS), a complex disorder characterized by co-occurrence of at least three of such factors as hypertension, obesity, dyslipidemia and insulin resistance. However, lifestyle interventions reduce the risk of both MetS and T2D, and nutrition education can empower individuals on the appropriate lifestyle changes. The aim of the current study was to evaluate the effect of a nutrition education programme, with and without inclusion of peer to peer support, on MetS in T2D patients. Methods This was a randomized controlled trial with two intervention groups and one control. One of the intervention groups involved a nutrition education programme with peer-to-peer support (NEP); the other involved only the education program, while the control received standard care. Each group had 51 participants. The nutrition education programme was conducted for 2h per week for 8 weeks. In addition, the NEP had weekly peer-to-peer interactions for 8 weeks. All groups had follow-up sessions for 6 months. Data on MetS risk factors as well as food intake patterns and physical activity levels were taken at baseline and at different time points during the study. Analysis of Co-variance and regression were used in the analysis. Results: The MetS prevalence improved in the NEP (90% to 52%) and NE (86% to 69%),while it worsened in C (88% to 91%). There was improvement in the mean values of the anthropometric parameters in the NEP and NE which worsened in the control group. There was a general improvement in mean values of blood lipids, fasting blood glucose and HbA1c in all the groups, with NEP showing the greatest improvements, followed by NE, except for triglycerides and HDL where the control group had better improvement than the NE. Changes in the anthropometric and metabolic indicators mirrored the changes in food intake patterns and physical activity, where the greatest improvements occurred in the NEP. Conclusions: Nutrition education with inclusion of peer to peer support was of clinical benefit in improving metabolic outcomes and reducing MetS in T2D patients.

Maternal and Child Health Journal, Aug 21, 2012

To determine utilization of iron and folic acid supplementation services among pregnant women in ... more To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4 days in a week were considered "highly compliant". The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6 % obtained antenatal care in the first trimester; 69.3 and 51.2 % received folic acid and iron supplements, respectively. However, only half (45-58 %) received any information about supplementation. Most women were initiated on folic acid (80.7 %) or iron (67.7 %) after 12 and 16 weeks of gestation, respectively, well after the recommended time period. However, more than 80 % of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels < 11 g/dl) was 7.8 %. Health workers need to better explain the importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem.

International journal of diabetes and endocrinology, 2019

Type 2 diabetes is a public health problem and one of the most common life threatening conditions... more Type 2 diabetes is a public health problem and one of the most common life threatening conditions globally, due to its related complications that are usually very costly to treat, with increasing number of people being diagnosed with this condition each year. Presence of the metabolic syndrome (MetS) and cardiovascular risks in Type 2 Diabetes patients increases the risk to complications. The objective of this study was to determine characteristics of type 2 diabetes patients and their association with MetS and associated cardiovascular risk. The study employed a cross section design method. Subjects with Type 2 Diabetes were recruited for the study from Thika Level Five Hospital in Kenya. Socio-demographic, clinical and lifestyle data were obtained using questionnaires. The nutrition status was determined by anthropometry. Other laboratory parameters that were determined included total cholesterol (TC), high density cholesterol (HDL-c) and low density cholesterol (LDL-c), triglyceride (TG), fasting blood glucose (FBG), glycated haemoglobin (HbA1C), and blood pressure (BP). Overall 153 (40.5% men and 59.5% women) Type 2 diabetic patients aged 20-79 years were included in the study. The overall mean age of patients was 56.07 years. The prevalence of the metabolic syndrome was 86.3% as per WHO criteria. The MetS components were elevated waist circumference (WC, 90.8%), increased waist hip ratio (WHR, 86.9%), elevated blood pressure (65.7% & 72.5%) and elevated triglycerides (64.8%). The prevalence of occurrence of the components of the MetS was not significantly different among male and female patients except for WC, BMI and reduced serum HDL-C where women were at a significantly higher risk than men (P≤0.00.). The current study showed that income was associated with elevated diastolic blood pressure (BP), secondary education and years lived with diabetes were associated with elevated TG, while occupation showed some association with high WHR. Additionally Gender, marital status and type of residence were associated with elevated HDL while education, family history of diabetes and alcohol intake was associated with obesity. The prevalence of the MetS and associated cardiovascular risk among Type 2 Diabetes patients was high and similar among males and females. Enhanced surveillance on Mets and associated cardiovascular risk in Type 2 Diabetes in addition to application of preventive measures are critical in order to reduce the risk of macro vascular complications as well as increased cardiovascular risks in Type 2 Diabetes patients.

Scientific African, Jul 1, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Food Research International, Mar 1, 2016

Abstract Different mechanisms responsible for the development of the hard-to-cook defect in commo... more Abstract Different mechanisms responsible for the development of the hard-to-cook defect in common beans during storage, their soaking behavior and softening during thermal treatment have been previously suggested. However, these mechanisms have not been sufficiently confirmed by direct molecular evidence. This research aimed at gaining a detailed mechanistic insight into changes occurring in Canadian wonder bean pectic polysaccharides during storage, soaking and/or thermal treatment in different brine solutions in relation to the development and manifestation of the hard-to-cook (HTC) defect. Both fresh or easy-to-cook (ETC) and stored (HTC) bean samples were either soaked or soaked and thermally treated in demineralized water, solutions of Na2CO3 and CaCl2 salts followed by extraction of cell wall materials. Pectic polysaccharide properties examined included sugar composition, degree of methylesterification (DM), extractability and molar mass (MM). The DM of pectin from ETC and HTC beans was similar but low (

African Journal of Health Sciences, Sep 17, 2020

INTRODUCTION Civil Society Organizations (CSOs) play a major role in HIV/AIDS response. Despite t... more INTRODUCTION Civil Society Organizations (CSOs) play a major role in HIV/AIDS response. Despite their massive effort to promote health care, nutrition and socioeconomic empowerment to people living with the disease, documented data on the impact and value of their interventions remain scanty. Globally, people infected with HIV/AIDS by 2018 were estimated to be 37.9 millions recording 1.1 million mortalities in that year. HIV prevalence rate in Kenya was at 4.9% among the general population of ages 15-64 years [2]. In other reports, the national HIV prevalence was at 4.5% while males and females aged 15 to 24 years at 5.2% in 2018. Busia County had HIV prevalence rate of 7.7% in the same year [1]. AIM The objective of this study was to determine the effect of CSOs interventions on health, nutrition and economic status of people living with HIV/AIDS in Busia County. MATERIALS AND METHODOLOGY A quasi-experimental study design was done with structured and non-structured questionnaires administered to two hundred and twenty (220) participants at baseline and end line by registered CSOs with other facilitators. All permanent male and female residents infected with HIV aged between 15 and 64 years from comprehensive patient attendance lists obtained from the Ministry of Health (MoH) facilities qualified for the study. All respondents signed informed consent forms prior to participation. Qualitative in-depth data was obtained through focus group discussions(FGDs) from key informant interviews. RESULTS No statistically significant differences were reported due to gender, household size and education level recorded in both sites at baseline and end line. Access to HIV/AIDS information was higher in CSOs intervention sites (89.5%) than in non-intervention (73.2%) sites at end line. Respondents in the intervention group had a significant improvement in sourcing Antiretroviral (ARVs) drugs especially from private facilities (P<0.05) but no scientific difference in access to health care services between sites after CSOs intervention. Respondents receiving support for Income Generating Activities (IGA) reduced by 2.1% in the intervention sites at end line. Respectively those in non-intervention sites increased by 4.1%. The negative 6.2% Net Effect of Intervention (NEI) reported was nonetheless not statistically significant (OR=0.98 (95% CI=0.42-1.5), p=0.48). brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by AJOL-African Journals Online CONCLUSION CSOs intervention did not have a significant effect on access to HIV/AIDS information, access to health care services, their morbidity patterns, food intake and nutritional status as well as on economic status and income generating activities. This could be due to reports that, some implementing organizations lacked adequate documentation (comprehensive database, reliable and consistent data), eventually, often failing to monitor and evaluate projects they initiated. RECOMMENDATIONS CSOs should work in collaboration with the government to develop sustainable interventions aimed at empowering PLWHA in improving their livelihood not only in Busia County but also across the Country. Access to ARVs from the nearest health facility will reduce suffering especially from opportunistic infections.

Nutrition and food technology, 2019

Amaranth sorghum grains complementary food is a nutrient dense dry food product for infants and y... more Amaranth sorghum grains complementary food is a nutrient dense dry food product for infants and young children. It is prone to moisture absorption from the environment and fat oxidation depending on packaging and storage condition due to its low moisture content and high level of unsaturated fat. In this study, amaranth sorghum grains complementary food was stored in three types of packaging material namely, kraft paper, kraft paper with polyethylene lining and aluminium pouch being the commonly used packaging materials for dry complementary foods in Kenya. These packaged samples were stored at ambient, 25°C, 60% relative humidity and 35°C, 75% relative humidity for 180 days. The moisture content of the product and the peroxide value of the oil extracted from the product were determined using the standard methods at an interval of 45 days for 180 days. The initial peroxide value of the product at day zero was 0.48 meq O 2 Kg-1 while its moisture content was 3.7% on dry weight basis. Over the 180 days of storage, aluminium pouch was the most effective package in controlling increase in moisture content and peroxide value in comparison to the other two packages. Samples stored at 35°C, 75% RH had a shorter shelf life compared to those stored at 25°C, 60% RH and ambient conditions. It is recommended that the product should be stored below 25°C and packaged in aluminium pouch to achieve a longer shelf life.

Central African Journal of Public Health, 2018

Pica is an indicator of low micronutrients in a pregnant woman's health. Low micronutrients pose ... more Pica is an indicator of low micronutrients in a pregnant woman's health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene's test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.

Scientific Conference Proceedings, Sep 7, 2012

Antioxidant capacity, phytochemicals, phyto-nutrients and bioactive compounds, have all become bu... more Antioxidant capacity, phytochemicals, phyto-nutrients and bioactive compounds, have all become buzzwords in the growing market for natural health food-products and speciality juice drinks. The main objective of this study was to determine the bioactive compounds in the calyces of Hibiscus sabdariffa L. and evaluate its functional potential hence provide an incentive to production, processing and consumption of roselle in Kenya where it is not widely cultivated and utilized. Proximate composition was determined using established AOAC methods. Antioxidant activity (AA) color degradation index (CDI) and were carried using 1-1 diphenyl picryl hydrazyl radical (DPPH) and hunters color meter respectively. HPLC, UV-visible spectrophotometer and atomic absorption spectrophotometer (AAS) were used to determine water soluble vitamins (WSV), total polyphenolic content (TPC) and mineral composition respectively. Product formulations were done and their consumer acceptability determined based on a 9-point hedonic. It was found that the properties of roselle extract before and after pasteurization included pH of 3.88 ± 0.00 and 3.42 ± 0.01, total acidity (as malic acid) of 2.24 ± 0.00 and 2.24 ± 0.03 %, total phenolic contents of 6.06 ± 0.18 and 5.82 ± 0.01 mg/g roselle extract, respectively. The antioxidant activities using DPPH assay with ascorbic acid standard, expressed as EC50 (Efficient Concentration) were 230.01 ± 2.40 and 235.34 ± 0.79 μg/ml, respectively. Iron and calcium were content was 8.59 ± 0.31 and 14.83 ± 0.60 mg/100g respectively. After sensory analysis, the pure roselle drink was generally more acceptable in taste, flavor, aroma, consistency and overall characteristics with an average overall score of 7.6 out of 9 in comparison with Rosela orange drink, rosella apple drink and rosella melon drink. These properties give roselle the potential as a functional ingredient in beverage manufacture and other applications such as utilisation in polymeric natural color development. Roselle can also be applied in the food industry for manufacture of red wine and roselle fruit flavored preserves, thus exhibiting great potential in commercial application in the food and pharmaceutical industry. More studies for in-vivo properties of Roselle extracts are however needed, to further substantiate the health claims of roselle extract in human nutrition.

Zenodo (CERN European Organization for Nuclear Research), Jun 30, 2022

Outlets for sexual health servicesare increasingly becoming a global public health concern in sex... more Outlets for sexual health servicesare increasingly becoming a global public health concern in sexual reproductive health of the youth as they struggle to balance their pursuant and performance in education and the effect of their sexual behavior on their lives. Studies have indicated that access to basic sexual reproductive health services continue to jeopardize the health of the youth as they struggle to also cope up with the consequences associated with the growing health needs from emerging public health concerns. The Ministry of Health in Kenya is recording high prevalence of sexually transmitted infections including HIV amongst the youth. Urban residents have a significantly higher risk of HIV infections (7.2%) than rural residents (6.0%) A majority of annual new HIV/AIDS infections occur among youth aged 15-24 years, the majority of whom are in secondary school levels due to their high sexual activity. The main objective of this study was to determine outlets for sexual health services amongst youth in secondary schools in Mukuru slums in Nairobi. The study adopted a cross sectional descriptive design that utilized both quantitative and qualitative techniques of data collection. The study was conducted in three purposively selected secondary schools in Mukuru slum, Nairobi County amongst the youth aged 15 to 24 years. A sample size of 335 was determined and stratified sampling procedure was used. Data was collected using semi structured questionnaire and 6 focus group discussions which were both administered and conducted amongst the study population. This study received scientific and ethical approval from the Scientific Steering Committee at the Kenya Medical Research Institute. Participants were taken through all the consenting processes prior to their acceptance to participate in the study. The results show that there were more females (57.8%) respondents than males (42.2%). Many of the female respondents (81.1%) indicated that they had first sex before they turned 10 years than few male respondents (12.2%). About 50% of respondents visited private facilities to seek medication services. Among those who visited public hospitals, 27% of the respondents sought services for consultation, lab, and medicine while 13% of the respondents indicated that they visited traditional healers. There were many females (21.8%) who indicated that they visited private hospitals for STI treatment. However, the type of outlet or facility (p-value 0.000<0.05) significantly influenced the services that the respondents sought at the outlet or facility. This study concludes that despite the many outlets offering SRH services, many youth in schools engage in sexual risky behaviours that exposes them to harmful consequences such as early pregnancies, abortions and STIs. There is a need for the Ministry of Health to develop a working partnership with the outlets for SRH to develop and monitor youth friendly essential packages that will meet the most pressing SRH needs of youth in schools and young adults in slum settings.

Journal of Diabetes & Metabolic Disorders

Despite the increased use of mobile phone communication in Kenya, its application as a management... more Despite the increased use of mobile phone communication in Kenya, its application as a management tool in health care remains largely underutilized. This study aimed at evaluating the effect of mobile phone communication on drug adherence amongst Type 2 Diabetes Mellitus (T2DM) patients. This longitudinal study was conducted among 138 T2DM patients attending the diabetes clinic at Kitui County Referral Hospital. A structured questionnaire was used to obtain information on respondents’socio economic and socio demographic characteristics and drug adherence practices. Data was analyzed using SPSS version 21. After six months, the proportion of respondents who took their drugs at specific times increased from 58.2% to 74.6% in the intervention group (IG) compared to a decrease of 47.9% to 46.5% in the control group (CG). The Net Effect of Intervention (NEI) increase of 17.8% was statistically significant (p<0.05). The proportion of respondents who did not miss their diabetes drugs increased from 65.7% to 79.1% in the IG compared to a decrease from 63.4% to 54.9% in the CG, marking a significant NEI increase of 21.9% (p<0.05). Use of mobile phone communication increased adherence to diabetes medication in the aspects of no delayed and missed doses in Type 2 Diabetes Mellitus patients in this study.

East African Medical Journal, 2020