Association of Dietary Diversity and Microbial Safety of Food on Nutritional Status of Children Aged 6-59 Months in Sedentarised Pastoral Households, Marsabit County, Kenya

Abstract

The transition from nomadic to sedentary pastoralism has introduced dietary changes among previously nomadic communities. However, limited information exists on how these practices affect the nutritional status of children aged 6–59 months, particularly regarding complementary food safety. This study assessed the impact of dietary diversity and microbial safety of foods on the nutritional status of children in Marsabit County, Kenya. A cross-sectional survey across six wards targeted children aged 6–59 months. Using multistage sampling, 394 children participated with caregiver consent. Data collection involved pre-tested questionnaires and anthropometric measures. For food safety, samples of food (127), water (27), and hand swabs (48) were collected from 127 households. Fumonisin and aflatoxins were analyzed using immuno-affinity columns (AccuScan Gold®), while AFM1, AFM2 in milk, and AFB1, AFG1, AFB2, and AFG2 in cereals were assessed using HPLC-FD. Microbial analysis included total viable, coliform, yeast, and mold counts, with Escherichia coli and Salmonella spp. identified via AOAC methods. Descriptive statistics and tests, such as chi-square and ANOVA, summarized population data, while linear and logistic regressions explored undernutrition predictors (p < 0.05). Results showed stunting, underweight, and wasting prevalence at 38.1%, 23.0%, and 18.5%, respectively, with 97% of children consuming mainly grains, roots, and tubers. About 51.5% did not meet the minimum dietary diversity score. Consuming legumes and eggs reduced stunting odds (OR=0.50, p=0.010), while dairy intake reduced underweight risk (AOR=2.09, p=0.015). Median fumonisin (300 μg/kg) and aflatoxins levels exceeded EU standards, with median AFB1, AFM1, and AFM2 also above regulatory limits. Mean microbial loads (± SE) for total viable counts, coliforms, yeast, and molds surpassed KEBs and EU values. Salmonella spp. prevalence was highest in Bubisa (57%), with E. coli detected in all tested foods. High viable counts increased underweight risk (AOR=4.304, p=0.004), while molds and E. coli correlated strongly with stunting (AOR=1.314, p<0.001; AOR=1.88, p=0.008). The study reveals high stunting and underweight rates linked to cereal-based diets and inadequate food hygiene. Raising caregiver awareness of food handling in sedentary pastoral settings is essential. Further research on mycotoxins should include biomarker assessments and identifying specific E. coli and Salmonella strains linked to stunting and underweight