Vitamin A deficiency (VAD) persists in Uganda and the consumption of β-carotene-rich orange sweet potato (OSP) may help to alleviate it. Two large-scale, 2-y intervention programs were implemented among Ugandan farmer households to promote the production and consumption of OSP. The programs differed in their inputs during year 2, with one being more intensive (IP) and the other being reduced (RP). A randomized, controlled effectiveness study compared the impact of the IP and RP with a control on OSP and vitamin A intakes among children aged 6-35 mo (n = 265) and 3-5 y (n = 578), and women (n = 573), and IP compared with control on vitamin A status of 3- to 5-y-old children (n = 891) and women (n = 939) with serum retinol <1.05 μmol/L at baseline. The net OSP intake increased in both the IP and RP groups (P < 0.01), accounting for 44-60% of vitamin A intake at follow-up. The prevalence of inadequate vitamin A intake was reduced in the IP and RP groups compared with controls among children 6-35 mo of age (>30 percentage points) and women (>25 percentage points) (P < 0.01), with no differences between the IP and RP groups of children (P = 0.75) or women (P = 0.17). There was a 9.5 percentage point reduction in prevalence of serum retinol <1.05 μmol/L for children with complete data on confounding factors (n = 396; P < 0.05). At follow-up, vitamin A intake from OSP was positively associated with vitamin A status (P < 0.05). Introduction of OSP to Ugandan farming households increased vitamin A intakes among children and women and was associated with improved vitamin A status among children.

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Disease will likely spread into central Uganda.

BackgroundAs part of the HarvestPlus provitamin A-biofortified cassava program in Nigeria we conducted a survey to determine the cassava intake and prevalence of vitamin A deficiency among children 6-59 months and women of childbearing age in the state of Akwa Ibom.MethodsA cluster-randomized cross-sectional survey was conducted in 2011 in Akwa Ibom, Nigeria. The usual food and nutrient intakes were estimated using a multi-pass 24-hour recall with repeated recall on a subsample. Blood samples of children and women were collected to analyze for serum retinol, serum ferritin, and acute phase proteins as indicators of infection. Vitamin A deficiency was defined as serum retinol <0.70 μmol/L adjusted for infection.ResultsA total of 587 households of a mother-child dyad participated in the dietary intake assessment. Cassava was very widely consumed in Akwa Ibom, mainly as gari or foofoo. Daily cassava consumption frequency was 92% and 95% among children and women, respectively. Mean (±SD) cassava intake (expressed as raw fresh weight) was 348 ± 317 grams/day among children and 940 ± 777 grams/day among women. Intakes of most micronutrients appeared to be adequate with the exception of calcium. Median vitamin A intake was very high both for children (1038 μg RAE/day) and women (2441 μg RAE/day). Red palm oil and dark green leafy vegetables were the main sources of vitamin A in the diet, with red palm oil alone contributing almost 60% of vitamin A intake in women and children. Prevalence of vitamin A deficiency ranged from moderate (16.9 %) among children to virtually non-existent (3.4 %) among women.ConclusionConsumption of cassava and vitamin A intake was high among women and children in Akwa Ibom with a prevalence of vitamin A deficiency ranging from moderate in children to non-existent among women. The provitamin A biofortified cassava and other vitamin A interventions should focus dissemination in states where red palm oil is not widely consumed.

Background There is little evidence of the impact of integrated programs distributing nutrition supplements with behavior change on infant and young child feeding (IYCF) practices. Objective We evaluated the impact of an integrated IYCF/micronutrient powder intervention on IYCF practices among caregivers of children 12–23 mo in Eastern Uganda. Methods We used pre-/post- data from two population-based, cross-sectional surveys representative of children aged 12–23 mo in Amuria (intervention) and Soroti (non-intervention) districts (N = 2,816). Caregivers were interviewed in June/July at baseline 2015 and 12 mo after implementation in 2016. We used generalized linear mixed models with cluster as a random effect to calculate the average intervention effect on: receiving IYCF counseling; ever breastfed, current breastfeeding, bottle feeding, introducing complementary feeding at age 6 mo, continued breastfeeding at ages 1 and 2 y, minimum meal frequency (MMF), minimum dietary diversity, minimum acceptable diet (MAD), and consumption of food groups the day preceding the survey. Results Controlling for child age and sex, household wealth and food security, and caregiver schooling, the intervention was positively associated with having received IYCF counseling by village health team (adjusted prevalence difference-in-difference [APDiD] +51.6%; 95% Confidence Interval [CI] 44.0, 59.2), timely introduction of complementary feeding (APDiD + 21.7%; 95% CI 13.4, 30.1), having consumed organs or meats (APDiD + 9.0%; 95% CI 1.4, 16.6), vitamin A-rich fruits or vegetables (APDiD + 17.5%; 95% CI 4.5, 30.5), and MMF (APDiD + 18.6%; 95% CI 11.2, 25.9). The intervention was negatively associated with having consumed grains, roots, or tubers (APDiD -4.4%, 95% CI -7.0, -1.7) and legumes or nuts (APDiD -15.6%; 95% CI -26.2, -5.0). Prevalence of some IYCF practices were low in Amuria at endline including MAD (19.1%). Conclusion The intervention had a positive impact on several IYCF practices; however, endline prevalence of some indicators suggests a continued need to improve complementary feeding practices.