Nutrition status, health risks factors and food security of older people living in Kass Province (South Darfur)--case study: Shattaya Fur.

Bashir, Samia ; Abdel Magied, Ahmed ; Salih, Osama Awad 等

Abstract

In the present investigation, a population of 250 older females and males from Fur tribe of Shattaya in Kass locality, in South Darfur State were investigated for their nutrition status, health risk factors and food security. The ages of the respondent were 55 years and above. The overwhelming majority (95.8%) had previous occupation as farmers and owned land. Although most of the women were farmers, at present most of them are only housewives in their new displaced situation. Shattaya Fur do not have any income source, which is contrary to the majority of Fulani tribe who had high income and whose area has not been affected by the current war events; hence they have affluent life (Saad, 2005).

The mild situation of chronic diseases (Diabetes mellitus and hypertension) among Shattaya Fur is comparable to that of the Fulani tribe on Tulus. This phenomenon could be due to genetic factors and/or the rural living style of Southern Darfur State. The nutrition status situation, regarding the different levels of malnourishment is very grave and alarming. The results have shown that the majority (60.8%)were normal, 10.4% severely malnourished, 14.4% moderately malnourished, 9.6% mildly malnourished and only 4.8% were overweight. When compared to the nutrition status of the Fulani tribe of Tulus (Saad, 2005), the picture is reversed. Contraction of epidemic diseases (e.g. malaria) was pronounced within the age group 55-64 years and contraction of diarrhea and Bilharzia among the respondents does not seem alarming. Joints pain was common among all age groups, while Rheumatism was also found in all age groups except the age group 85 and above. Regarding their physical status, the majority seemed to be normal. With the exception of the age group 55-64 years, the other age groups showed varying degrees of poor chewing ability and poor eyesight.

Significant difference between sexes (P = 0.009) were found in physical status (P= 0.00) and BMI (P = 0.035).

Insignificant differences were found between sex and Diabetes (P = 0.730), sex and Rheumatism (P = 0.838), sex and poor chewing ability (P = 0.339) and sex and poor eyesight (P = 0.840).

The prevailing war in Southern Drafut has created a situation of serious food insecurity in certain areas. Contrary to the Fulani older people from Tulus, (Saad, 2005), Shattaya Fur of the same state suffered from food in security and their situation of malnutrition is alarming.

Accordingly, relevant recommendations were made. Those include the immediate intervention of Sudan Government and relevant international agenesis, in particular Help Age International (HAI).

Introduction:

Life expectancy at birth is now 75 years, compared with about 47 years at the beginning of the 20th century. The increase in life expectancy observed through the past century suggests that diet, exercise and other personal and socio-economic factors could help prolong life and health for most people particularly in the industrial world.

Evidence confirms that good nutrition is important in maintaining the health and functional independence of older adults. Nevertheless, the chances are great that an individual in the eighth or ninth decade of life will be limited in activity requires health and social services (Older American Act, 2002).

In both developing and developed countries, chronic diseases are significant and costly causes of disability and reduced quality of life. The likelihood of experiencing major disabilities dramatically increases in very old age and within the 60 years of age and over (Second World Assembly on Ageing, 2002).

According to the Ministry of Health and UNICEF (2003), malnutrition rate was incredibly high (24.4%) in South Darfur. Accordingly, with the armed conflict still going on in Darfur at large, the food security situation will worsen. Nonetheless, in natural disaster, political and civil conflicts, older persons in Sudan are the last to receive assistance (Save the Children, UK, 2004).

Although unpublished literature on the nutritional status and health risk factors of older Sudanese people is available, yet very little is found in the published forms (Abdel Magied and Refaei, 2006; Ali and Abdel Magied, 2005; Saad and Abdel Magied, 2005).

Methodology:

The study was cross-sectional descriptive investigation. The study area was Kass Province (South Darfur State).

The studied population were older persons (55 years and above), both males and females. The sample size was 250 respondents who were randomly selected (125 males and 125 females).

Primary data was collected from the older persons through a pre-tested questionnaire and interviews. The nutritional status of the older persons was assessed by measuring their Body Mass Index (BMI) according to the following formula:

BMI = Weight in Kg / Height in [(Meter).sup.2]

The cut off points for determining the BMI were applied according to WHO (1993) and Ismail and Mandhar (1998):

If the BMI is

16: Indicates severe malnutrition

< 18.5: Indicates risks to be malnourished

Between 18.5 - 25: is normal.

Between 25-30: indicates risk to be obese.

Above 30: indicates obesity.

Quantitative data that were collected from the older persons was analyzed using the computer package SPSS.

Result and Discussion

The majority (74.8%) of the respondents were in the age group 5574 years of age; 20.4% were in the age group 75-84 and only 4.8% in the age of 85 and above, The overwhelming majority (95.8%) had previous occupation as farmers, while only 4.8% were previously occupied in animal raising. Although most of the women were farmers, at the time of investigation most of them were only housewives. The majority either had Khalwa / Church education (55.6%) or illiterate (39.6%), while only 4.8% had primary/intermediate educations.

This result overlaps with the findings of Saad's (2005) parallel study that was carried out on the Fulani ethnic group of Tulus in South Darfur. The majority (90.6%) of Shattaya Fur did not have any income source.

Contrary to that, the majority of the Fulani had high income and their area was not affected by the current events; thus, they live affluent life (Saad, 2005). The majority of Shattaya respondensts (80.8%) had either sons or daughters who reside in the same house or the same neighborhood, and 44.8% were not living alone. This would, however minimize the hazard of contracting depression. Only 5.2% were physically disabled and 44.4% used to cook alone, and the vast majority (89.6%) took food by themselves. The majority (70%) had a good memory. Those suffering from poor eyesight were 43.2%. The majority (76%) contracted malaria and 13.6% Bilharzia; 56% had joints pain. Those with dental problems were 55.6% and those suffering from poor food chewing ability were 50.4%. Accordingly, the many health risk factors they are exposed to were obvious. All of the respondents used to have only two meals per day, and as well had passed more that one day without food within the same week. However, the majority (79.2%) referred the situation to the unavailability of food. Nevertheless, a minor percentage (7.2%) of the respondents were suffering from Diabetes mellitus and none of them suffered from hypertension. This situation of Shattaya Fur in contracting Diabetes or absence of hypertension is comparable to the findings as genetically controlled. Nonetheless, this could also be due to the rural life style of the fur people and perhaps other ethnic groups in Southern Darfur. The BMI assessment results have shown that 60.8% were normal, 10.4% severely malnourished, 14.4% moderately malnourished, 9.6% mildly malnourished and only 4.8% were obese. However, the nutritional status situation in connection with the different levels of malnutrition is very grave when compared to the Fulani ethnic group as reported by Sadd (2005).

[FIGURE 1 OMITTED]

The overwhelming majority of the respondents within the age group 55-64 years contracted malaria (Figure 1). Since the latter age group was the more active one, perhaps they were more exposed to the contraction of the disease. Nonetheless, clear majorities contracted malaria within the age group 75-84 years and 75-84 years.

As in Figures 2 and 3, contraction of diarrhea and Bilharzias does not seem alarming.

[FIGURE 2 OMITTED]

[FIGURE 3 OMITTED]

Constipation (figure 4) was common to all the age groups between 55--84 years; strange enough none of those of the age group 85 years and above complained from constipation.

[FIGURE 4 OMITTED]

Within all age groups (Figure 5) many were complaining from joints pain; strange enough the picture for Rheumatism is reversed (Figure 6).

[FIGURE 5 OMITTED]

[FIGURE 6 OMITTED]

The overwhelming majority of the respondents regarding their physical status (figure 7) seemed to be normal except' the age group 55-64 years.

[FIGURE 7 OMITTED]

With the exception of the age groups 55-64 years, the other age groups showed varying degrees of poor chewing ability (figure 8).

[FIGURE 8 OMITTED]

Poor eyesight was found among all age groups (figure 9).

[FIGURE 9 OMITTED]

Diabetes among the respondents does not call for special attention (Figure 10). Howevre, being completely absent from the age groups (75-84 and 85 and above) seems interesting; a phenomenon that deserves further investigation.

[FIGURE 10 OMITTED]

Pertaining to the nutrition status (figure 11) the majority of the respondents within all age groups were normal, yet all respondents within age group 85 years and above had some degree of malnutrition.

[FIGURE 11 OMITTED]

In connection with the joints pain insignificant difference was found between the two sexes (P= 0.425). Insignificant difference between the two sexes has been shown in contracting Rheumatism. Regarding the relative distribution of physical status between the two sexes highly significant difference for males advantage (P=0.00) was found. There was insignificant difference regarding the relative distribution of sex and poor chewing ability (P=0.339). Same situation of insignificance (P= 0.840) in the relative distribution between sex and poor eyesight. This applies for contraction of Diabetes (P= 9.730). Regarding the nutrition status significant value (P= 0.035) was found for the relative distribution between the two sexes for males advantage.

The prevailing war in Southern Darfur has created a situation of serious food insecurity for certain areas. Contrary to the situation of Fulani older people from Tulus, (Saad, 2005), Shattaya Fur of the same State suffered from food insecurity hence, the situation of malnutrition was alarming and the whole population residing in Kalma camp completely depend on international food aid.

Conclusions and Recommendations

The following conclusions were reached:

* Although all women respondents were previously occupied as farmers, in their displaced situation their vast majority were only housewives. Also the majority of the respondents had no income source and mainly depended on food aid.

* The health risk factors among Shattaya Fur were more pronounced than those faced by Tulus Fulani tribe.

* The mild situation of chronic diseases (Diabetes and hypertension) among Shattaya Fur was comparable to that of the Fulani tribe from Tulus. This phenomenon could be due to genetic factors and/ or the rural living style in Southern Darfur State.

* The nutrition status regarding the different levels of malnutrition was very grave when compared to the Fulani ethnic group as reported by Saad (2005).

* Contraction of diarrhea and Bilharzia among the respondents did not seem alarming.

* Constipation was found common in all age groups with the exception of the age group 85 years and above.

* Poor chewing ability and poor eyesight were found in all age groups.

* Because of the war, food insecurity was accurate and malnutrition among the respondents was alarming and exceeding the emergency levels.

Therefore, the following recommendations were suggested:

* Sudan Government should make all arrangements that ensure the safety of the population in Kass locality.

* Sudan Government should provide the needed health services.

* The already acquired skills of older persons should furtherly be developed to enable them to contribute to sustainable development.

* Sudan Government strategy and polices should address all the problems of older people.

* International agencies concerned, particularly Help Age International are requested to contribute to sustainable development issues connected with older people in Darfur.

* The alarming situation of malnutrition among Shattaya Fur needs immediate serious intervention.

References:

(1.) Abdel Magied, Ahmed and El Refaie, Hind (2006): Nutrition Status, Health Risk Factors of Olders Women in Khartoum "2" .The Ahfad Journal. Vol. 23, No. 1 (Research Note).

(2.) Ali, B.F. Samia and Abdel Magied, Ahmed (2005): Nutrition Status, Health Risk Factors and Food Security of Older Person Living in Kass province (South Darfur State). The Ahfad Journal. Vol.22, No. 2 (Research Note).

(3.) Ministry of Health and UNICEF (2003): Food Security Sitiuation in South Darfur State.

(4.) Older American Act, OAA (2002): health and Ageing.

(5.) Saad, M. A. Mariam (2005): Nutrition Vulnerability and Health Risk Factors of Older Persons Living in Southern Darfur. Case study: Tulus Provinces, Dissertation submitted in Partial Fulfillment for the Award of M.Sc. in Sustainable Rural Development. Ahfad University for Women.

(6.) Saad, mariam and Abdel Magied, Ahmed (2005): Nutrition Vulnerability and Health Risk Factors of Older Persons Living in Southern Darfur. Case Study: Tulus Province, The Ahfad Journal, Vol. 22, No. 2 (Research Note).

(7.) Save the Children, UK (2004): Report of Security Situation in South Darfur. SCE UK.

(8.) WFP (2004): report of Inter Agency Assessment of Kass Locality. WFP/Nyala Sub-Office

Bashir, Samia; Abdel Magied, Ahmed, Salih, Osama Awad (School of Health Sciences and NCTR, Ahfad University for Women, Sudan)