Development of a nutrient-dense food supplement for HIV-infected women in rural Kenya using qualitative and quantitative research methods

Abstract

Objective: Formative research to facilitate the development, packaging and delivery of a culturally acceptable nutrition intervention for HIV-infected women in rural Kenya for an intervention trial. Design: Focus group discussion on three areas: (i) ingredients and form of the nutrition intervention, (ii) packaging and delivery and (iii) monitoring of adherence. Two single-blind taste tests with eleven different porridge formulations of various combinations of maize flour, soyabeans, peanuts, sorghum, mung beans, dried fish, raisins and dried whole milk. Follow-up acceptability focus group discussion was also conducted. Setting: Voi, Kenya, community based. Subjects: Focus group discussion and two taste tests (twenty-one women aged 16-55 years). Follow-up acceptability focus group discussion (four women enrolled in intervention trial). Results: The preferred porridge for taste consisted of maize, soyabeans and peanuts. For animal protein, dried whole milk and dried fish were used. Although the women disliked the taste of dried fish, it was acceptable if added in small undetectable quantities. Sugar over lime was favoured for taste. Women believed they could consume at least two cups of porridge per day without displacing their usual meals. The optimal delivery interval was believed to be every two weeks in individual serving packages. Women who had been consuming porridge for several weeks felt the taste was acceptable for long-term consumption. Conclusions: This formative research resulted in the development, packaging and delivery of a nutrient-dense food supplement using local ingredients to meet the dietary needs of the population and acceptable for daily consumption by women in Kenya for evaluation in an intervention trial.

Community outreach programs and major adherence lapses with antiretroviral therapy in rural Kakamega, Kenya

“…Nutritional supplementation is important for patient adherence (Weiser et al, 2010). Practical ideas for nutritional supplementation in Kenya have successfully been implemented (Ernst, Ettyang, & Neumann, 2014;Hong et al, 2012;Lim et al, 2009;Mamlin et al, 2009;Nagata et al, 2014), though government and donor funding commitments are needed to extend nutritional programmes more broadly (Haberer et al, 2017).…”

Leaf concentrate compared with skimmed milk as nutritional supplementation for HIV-infected children: a randomized controlled trial in Burundi

“…The Ca content of both supplements might be expected to ameliorate low bone mass, an effect of HIV infection that has been reported for children and adolescents ( 29 ) , although longer follow-up would probably be required to detect any such effects. Trials that aim to test novel dietary interventions would benefit from information obtained from qualitative research into local tastes and preferences ( 30 ) . Such research would, ideally, be conducted before the trial, but could also be conducted during the trial.…”

Harnessing the Health Benefits of Pulses (Fabaceae): Pulses (Fabaceae) Nutrient Contents & Phytochemical Composition.

“…The nutritional health of people with HIV/AIDS can be improved by incorporating pulse foods into meals to increase protein consumption & diversify diets (Odendo & Kimani, 2011). According to Hong SY et al (2013), adding pulses to other foods can increase their nutrient density & possibly slow the rate at which HIV develops into AIDS. In order to improve digestibility, dried pulses can either be taken whole or subjected to decortication (dehulling) removing seed coat (Siegel & Fawcett, 1976).…”