A BRIEF REPORT OF OUR EXPERIENCE WITH THE USE OF MUKENE –FORTIFIED MAIZE FLOOR AND DRIED MUKENE FISH POWDER SINCE 19th AUGUST 2010

We are grateful for the opportunity we have had to have a provision for nutritional support to some of our patients. We run a specialized HIV clinic at the Joint Clinical Research Centre and quite often we get both adults and children that need treatment for various HIV-related ailments but many of these patients present with malnutrition owing to a variety of reasons. Until recently, we have used “Plumpy–nut”, a ready to use therapeutic food (RTUF) which is peanut based as nutritional supplement particularly in the ambulant but malnourished children.

In August 2010, we received a donation of 2 food products from Akiba products limited. The larger of this consignment was maize floor fortified with Mukene fish powder in a ratio of 4:1 and the smaller consignment consisted of only Mukene fish powder.  Although we’d received information that the 2 food products were a rich source of calories, protein, minerals and vitamins, we were uncertain as to how these products would be received by our patients especially since this was the first time we used these food products and the majority of the recipients were children aged 2 to 10 years.

We decided to provide this food to the patients that were visibly malnourished and under weight. The main cause for the malnutrition in our population was food insecurity and insufficient knowledge on nutritious food preparation particularly for the children. In many instances of food insecurity, both the children and the care takers were malnourished. The care takers were asked about acceptability of fish by the children and they were initially given a small sample to prepare at home. When the child accepted the food then we increased the supply to 2 Kgs and 5Kgs depending on the ongoing need and acceptability. After a period of 1 to 2 months, the care takers later on gave us feed back of their experience with this food.

All the food recipients gained body weight of 0.5 to 1 Kg and none lost weight during that time. In most of the instances, the Mukene fortified maize flour was prepared as porridge and some of the children took a while to get used to the fish smell of the porridge but were very comfortable with it when prepared as a solid meal in a manner similar to the common Uganda dish of Ugali or posho. The unmixed Mukene fish powder was very popular because it could be mixed with any other food or sauce that the families had. To our surprise, some of them informed us they were already buying some Mukene flour but unlike those other similar products they had tried, this product had a fresh taste and was not bitter. Some care takers initially added herbal flavors like cinnamon, lemongrass and “Mujaaja”(a herb commonly added to tea in Kampala) to the porridge so as to improve acceptance by the children. Over 60 families have received these food products all have come back for more. The adults gained appetite and they report the children also to have gained appetite but we were unable to explain this finding. Many of the children got so much used to the porridge from the fortified flour and refused to revert to the plain maize porridge that they previously took before they received the fortified product.

There was one particular 8 year old total orphan on antiretroviral therapy and under the care of a grandmother, with food insecurity and very limited resources of her own and yet she was also looking after other orphans. This child had problems with adherence to treatment and was stunted. The clinic had supplied him with dried food rations e.g. posho, beans that were replenished on a weekly basis but without improvement. Eventually he was put on high protein-high RTUF popularly Known as “Plumpy nut” for close to 8 months until August 2010. The clinic staff made several home visits in attempts to improve his nutrition but without success and quite often he would be out competed for the food by the healthier children in the home. Because the fortified porridge was not comparable to the sweetness of the “Plumpy nut”, he didn’t receive as much competition for this food and was able to actually take all the food allocated to him and for the first time in many months, he was able to gain weight.

Because of the above clinical observations of weight gain among the children and the high acceptance rates of the families in need, we will greatly appreciate the chance to have the above food products (Mukene-Fortified maize floor and Mukene Fish powder) available in our clinic so that we can provide them to the children in need. This will lead to improved clinical outcomes as food supplementation to clients in need is an area where the clinic has been having challenges. 

 

Nutritional facts of maize flour, fish flour  & Fish enhanced maize flour (per 100g)
				Maize flour (MF)	Fish Flour (FF)	MF Enhanced with FF
Calorie content of Food   (Kcals)				342	333.2	344.2
Protein content   (g)				8.48	75.7	15.58
Fat content (lipids)      (g)				1.65	2.9	1.85
Carbohydrate content    (g)				77.68	Not Measured	77.9
Dietary Fiber content     (g)				7.4	Not Measured	7.6
Minerals Nutrition in maize flour
Calcium (Ca) content       (mg)				4	70	9.3
Iron (Fe) content      (mg)				0.52	1.9	1.1
Magnesium (Mg) content      (mg)				37	139	49.5
Phosphorus (P) content        (mg)				90	800	131.2
Potassium (K) content        (mg)				162	1391	184.9
Sodium (Na) content          (mg)				3	335	27.7
Zinc (Zn) content                (mg)				0.72	2.2	0.82
Vitamins Nutrition in maize flour
Vitamin C   (mg)				7.3	6.1	7.35
vitamin B-1  (mg)				0.0254	0.2	0.1
vitamin B-2  (mg)				0.085	0.3	0.1
Vitamin B-6 (mg)				0.071	1.1	0.2
Folic Acid content (µg)				1.85	29	5.1

-----------------------------------------------------------------------------------------------------------

Nutritional facts of mukene (fish) flour (per 100g)
				Mukene Flour
Calorie content of Food   (Kcals)				333.2
Protein content   (g)				75.7
Fat content (lipids)      (g)				2.9
Minerals Nutrition
Calcium (Ca) content       (mg)				70
Iron (Fe) content      (mg)				1.9
Magnesium (Mg) content      (mg)				139
Phosphorus (P) content        (mg)				800
Potassium (K) content        (mg)				1391
Sodium (Na) content          (mg)				335
Zinc (Zn) content                (mg)				2.2
Vitamins Nutrition
Vitamin C   (mg)				6.1
vitamin B-1  (mg)				0.2
vitamin B-2  (mg)				0.3
Vitamin B-6 (mg)				1.1
Folic Acid content (µg)				29

 Gen.Caleb k Akandwanaho salim saleh oriba (rtd)

                  AKIBA INTERNATIONAL LIMITED

                P O BOX 10508 KAMPALA UGANDA