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Original Article

Feeding practice among 6–36 months old in Tanzania and Uganda: Reliability and relationship with early childhood caries, ECC

, , &
Pages 1309-1318 | Received 07 Aug 2012, Accepted 10 Dec 2012, Published online: 21 Jan 2013
 

Abstract

Objective. To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC. Method. Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child–caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding. Results. Cohen's kappa for intake of sugar items ranged from 0.40–1.0, with no differences observed between average intakes at test–re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC. Conclusion. Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.

Acknowledgments

We would like to thank the Hospital Director of Haydom Lutheran Hospital for field work support in Manyara. Thanks to Dr Josephine Kayondo (JK) who was responsible for the data collection in Kampala and to Dr Joyce Masalu, Muhimbili University of Health and Allied Sciences, who commented upon an earlier version of this manuscript. Thanks' to the participants for making this study a reality.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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