Household Dietary Diversity, Wild Edible Plants, and Diarrhea among Rural Households in Tanzania

Abstract

Communities in Tanzania have an extensive history of using wild plants for nutritional and medicinal purposes. The high prevalence of food insecurity and infectious disease, combined with a lack of access to healthcare in rural areas, makes traditional plant sources of food and medical treatment a practical alternative for vulnerable households. In this study, the association between household consumption of wild edible plants and self-reported diarrhea across categories of household food security status was examined. Focus group discussions in four villages in Kilosa, Tanzania, were used to elicit coping strategies, including consumption of wild edible plants, employed during periods of food shortage. Data on household dietary diversity, food security, demographics, selfreported health, as well as socioeconomic status were collected using a structured survey administered to heads of households. The association between selfreported diarrhea and consumption of wild edible plants across categories of household food security status were determined using bivariate and multivariate statistical methods. Our results indicate that among the moderately food insecure, the odds of a household member having diarrhea was lower in consumers as compared to non-consumers of wild edible plants (OR 0.30 [0.12, 0.75], p <0.05). Consumption of wild edible plants appears to be a potential mediator of diarrheal diseases in food insecure populations, especially among the moderately food insecure. Further research on the contribution of wild edible plants to alleviation of food insecurity and related health outcomes in developing countries is needed. INTRODUCTION Diarrhea is one of the ten leading contributors to the global burden of disease (Lopez et al., 2006). In Sub Saharan Africa, more than 17 percent of children less than five years of age die from diarrheal diseases annually (UNICEF-WHO, 2009). Mortality from this health condition disproportionately targets individuals in lowand middle-income countries (Lopez et al., 2006), where food insecurity is highly prevalent (FAO, 2011). By definition, food security is attained when ‘all people, at all times, have physical and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life’ (FAO, 2001). Household food insecurity has been associated with diarrhea (Perez-Escamilla et al., 2009) and other diseases (Perez-Escamilla et al., 2009; Weigel et al., 2007). The synergistic relationship between food insecurity and poor health is apparent when diets lacking appropriate nutrients reduce the body's ability to resist disease, thus increasing susceptibility to pathogens in contaminated water or food that adversely impact health (Lonnerdal, 2000; Scrimshaw and SanGiovanni, 1997). Wild edible plants, many of which have nutritional (Weinberger and Msuya, 2004; Burlingame, et al., 2009) and medicinal benefits (Irungu et al., 2007; Johns and Chapman, 1995), are frequently underutilized as local solutions to food insecurity and associated health concerns (Flyman and Afolayan, 2006; Kaschula, 2008; Herforth, 2010). Consumption of wild edible plants has the potential to improve the health status of food insecure Cordeiro: Household Dietary Diversity, Wild Edible Plants, and Diarrhea amo