http://ir.mu.ac.ke:8080/jspui/handle/123456789/68 2026-08-26T19:27:54Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10467 The association between dietary diversity and depressive symptoms among adult population in rural Western Kenya Opondo, Charles; Kamadi, James; Akiruga, James; D. Pastakia, Sonak; Rosenberg, Molly Abstract Low dietary diversity is a predictor of depression in high-income countries, but evidence from low-income settings where poor nutrition and depression often co-occur is scarce. We examined the association between dietary diversity and depression in rural Western Kenya. We conducted a cross-sectional analysis of data collected between June and August 2025 from 311 participants enrolled in a group-based microfinance (‘BIGPIC’) program. Depression was measured using twenty-item Centre for Epidemiologic Studies for Depression Scale, and dietary diversity was assessed based on the consumption of five food groups in the previous 24 hours using a validated scale. We used linear regression models to estimate the association between high dietary diversity and depression scores and assessed effect measure modification by wealth status. Quantile regression was used to examine variation across the distributions of depression scores. Higher dietary diversity was associated with lower depression scores (adjusted β (95 % CI): −3·49 (–6·62, −0·38)). This association was stronger among individuals with lower wealth (adjusted β (95 % CI): −6·00 (–10·46, −1·42)), compared with those with high wealth (adjusted β (95 % CI): −0·53 (–4·76, 3·68); Wald P–value for interaction = 0·0003). Effect sizes were larger at higher quantiles across 75th (Q75: β = −7·56; 95 % CI: −12·82, −2·27) and 90th (Q90: β = −6·01; 95 % CI: −12·43, 0·43) quantiles, though estimates were imprecise. These findings suggest that greater dietary diversity may be associated with improved mental health, par- ticularly among socio-economically vulnerable individuals, and those with severe depression. Future work using longitudinal and quasi-experimental designs are needed to strengthen causal inference and clarify underlying mechanisms 2026-05-08T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10452 The relationship between an Agricultural intervention integrated within a group-based microfinance program and depression and psychological stress in rural Kenya Opondo, Charles; Kamadi, James; Amisi, James Akiruga; Camplain, Ricky; Pastakia, Sonak D.; Ludema, Christina; Molly, Rosenberg Background Poverty is a social determinant of poor mental health outcomes. Agricultural interventions may reduce the burden of poor mental health outcomes for depression, and stress by enabling economic pathways out of poverty, particularly when paired with a group-based microfinance programs that provide complementary economic support. We estimated the relationship between an agricultural intervention, depression and psychological stress outcomes. Methods We conducted a cross-sectional survey using validated depression and stress scales among 312 participants. The exposed group received farm inputs and agribusiness trainings. We fit an adjusted multivariate linear regression models to estimate the association for depression and stress scores, in addition to a quantile regression model to examine variation of effect sizes across depression score quantiles. We tested for effect measure modification by wealth status as measured with a composite score derived from 20-household and agricultural assets. Results The agricultural intervention was associated with lower depression (β = −1.81; 95% CI: −4.24, 0.62) and stress scores (β = −1.39; 95% CI: −3.35, 0.56), but estimates were imprecisely measured. The association was strong in those with highest depression scores (Q90: β = −7.30; 95% CI: −13.59, −0.99), and weaker in those with lower depression scores (Q10: β = −0.7; 95% CI: −2.93, 1.48). There was no effect measure modification by wealth status (Wald p = 0.24), although larger effect sizes for depression were observed in those with low household wealth (β = −5.23; 95% CI: −10.75, 0.33). Conclusion An agricultural intervention was associated with modestly lower depression and stress scores, although overall estimates were imprecise. The association was strongest among individuals with severe depression, suggesting agricultural support may be beneficial for those experiencing greater psychosocial burden. Integrating agricultural support into microfinance programs may reduce depression among individuals with greater need. Future longitudinal work with larger samples may improve our causal understanding of these relationships 2026-07-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10451 The association between an agricultural intervention integrated within a group-based microfinance program and dietary diversity in rural Kenya Opondo, Charles; Kamadi, James; Amisi, James Akiruga; Camplain, Ricky; Sonak, Pastakia,; Nana, Gletsu-Miller,; Molly, Rosenberg Low dietary diversity is a risk factor for micronutrient deficiencies. Agricultural interventions that support crop production and livestock rearing may promote dietary diversity and achieve better nutritional outcomes, particularly among low-income households. Their effectiveness may be strengthened when integrated within microfinance platforms. The objective of this study was to estimate the association between an agricultural intervention delivered within a group-based microfinance program and dietary diversity in rural Western Kenya, and determined effect modification by sex. We conducted a cross-sectional design from June to August 2025 in two village wards of Webuye sub-County in rural Western Kenya, using a validated dietary diversity scale to assess the total number of food groups consumed in the previous 24 hours. We interviewed 312 microfinance participants, 156 of whom were in agricultural intervention comprised of farm input subsidies and training, while 156 were not in the intervention. We specified modified Poisson models to estimate the association between intervention receipt and dietary diversity, and tested whether the estimated association differed by sex. Participation in the agricultural intervention was associated with higher diversity among microfinance program members [adjusted PR (95% CI): 1.46 (1.02, 2.06)]. We did not find evidence that the association differed by sex (Wald p-value for interaction term=0.83). Participation in an agricultural intervention was associated with improved dietary diversity. Future prospective using large samples studies should build on these findings to establish temporal ordering, and assess the feasibility and sustainability of integrating agricultural support into microfinance platforms to improve dietary diversity in low-resource settings. 2026-07-01T00:00:00Z http://ir.mu.ac.ke:8080/jspui/handle/123456789/10438 Delays in Tuberculosis Treatment smong people with pulmonary tuberculosis in East Africa: findings from a prospective cohort study Prabhudas-Strycker, Kirsten; Diero, Lameck; Muyindike, Winnie; Byakwaga, Helen; Kitur, Sylvia; Mining’wo, Joseph; Ssekyanzi, Bob; Byaruhanga, Alexis; Kooreman, Harold; Pabon-Rodriguez, Felix; Truong, Hong-Ha M.; Lewis Kulzer, Jayne; Ochomo, Edwin; Odhiambo, Francesca; Goodrich, Suzanne; Semeere, Aggrey; Navuluri, Neelima; Wools-Kaloustian, Kara; Enane, Leslie A. Background. Although timely tuberculosis (TB) diagnosis and treatment are essential to TB elimination, care delays remain a challenge. Understanding factors associated with delayed TB diagnosis and treatment may inform interventions. Methods. The TB Sentinel Research Network of the International epidemiology Databases to Evaluate AIDS (IeDEA) is a prospective study of people aged ≥15 years with pulmonary TB. At sites in Eldoret, Kenya, and Mbarara, Uganda, questionnaires ascertained timing of recalled TB symptom onset, number/setting of healthcare visits prior to TB diagnosis, symptoms, demographics, food insecurity, and TB- and HIV-related stigma. Robust negative binomial regression was used to examine factors associated with longer overall duration from TB symptom onset to documented treatment initiation. Results. Among 264 participants—median age 33 years (IQR, 25–43 years), 67% male, 31% people with HIV, 51% urban residents—median duration from TB symptom onset to treatment initiation was 65.5 days (IQR, 33–131 days). Longer time to TB treatment was associated with female sex (adjusted incidence rate ratio [aIRR], 1.27 [95% CI, 1.00–1.61]); previous careseeking at a pharmacy (aIRR, 1.53 [95% CI, 1.22–1.92]), and presence of dyspnea (aIRR, 1.43 [95% CI, 1.09–1.86]) or fatigue (aIRR, 1.63 [95% CI, 1.11–2.37]) at initiation. Shorter duration to TB treatment was associated with HIV-positive status (aIRR, 0.50 [95% CI, .39–.64]). Among people with HIV, shorter duration to TB treatment was associated with CD4 count <200 cells/μL (aIRR, 0.63 [95% CI, .43–.93]). Conclusions. Interventions are needed to increase community-level TB diagnostic access, including at pharmacies and lower levels of care. Decentralized TB testing strategies and tailored interventions for groups with lower care access should be pursued. 2026-07-10T00:00:00Z