Seventeen per cent of the world's population is estimated to be at risk of inadequate zinc intake, which could in part be addressed by zinc fortification of widely consumed foods. We conducted a review of efficacy and effectiveness studies to ascertain the effect of zinc fortification [postharvest fortification of an industrially produced food or beverage; alone or with multiple micronutrients (MMN)] on a range of health outcomes. Previous reviews have required that the effect of zinc be isolated; because zinc is always cofortified with MMN in existing fortification programs, we did not impose this condition. Outcomes assessed were zinc-related biomarkers (plasma or serum, hair or urine zinc concentrations, comet assay, plasma fatty acid concentrations, and the proportion of and total zinc absorbed in the intestine from the diet), child anthropometry, morbidity, mortality, cognition, plasma or serum iron and copper concentrations, and for observational studies, a change in consumption of the food vehicle. Fifty-nine studies were included in the review; 54 in meta-analyses, totaling 73 comparisons. Zinc fortification with and without MMN increased plasma zinc concentrations (efficacy, n = 27: 4.68 μg/dL; 95% CI: 2.62–6.75; effectiveness, n = 13: 6.28 μg/dL; 95% CI: 5.03–7.77 μg/dL) and reduced the prevalence of zinc deficiency (efficacy, n = 11: OR: 0.76, 95% CI: 0.60–0.96; effectiveness, n = 10: OR: 0.45, 95% CI: 0.31–0.64). There were statistically significant increases in child weight (efficacy, n = 11: 0.43 kg, 95% CI: 0.11–0.75 kg), improvements in short-term auditory memory (efficacy, n = 3: 0.32 point, 95% CI: 0.13–0.50 point), and decreased incidence of diarrhea (efficacy, n = 3: RR: 0.79, 95% CI: 0.68–0.92) and fever (efficacy, n = 2: RR: 0.85, 95% CI: 0.74–0.97). However, these effects cannot be solely attributed to zinc. Our review found that zinc fortification with or without MMN reduced the prevalence of zinc deficiency and may provide health and functional benefits, including a reduced incidence of diarrhea.

Background Malaria is the top public health problem in the Republic of Guinea, with more than 4 million cases and 10,000 deaths in 2021 among a population of approximately 13 million. It is also the second highest cause of death there. The purpose of this quantitative survey in a rural area of Guinea was to understand knowledge, attitudes, and practices (KAP) about malaria and to assess water and sanitation practices among community members. Methods In 2016, the authors conducted a cross-sectional household survey in Timbi-Touni, Guinea using community workers. The survey included respondent demographic characteristics, malaria knowledge, child health, water and sanitation, and health services access. Malaria knowledge and sleeping under bed nets were the primary outcome variables and multiple logistic regression was used to determine odds ratios. Results Majority of the respondents were women (89.41%) and had never been to school (71.18%). Slightly more than half the children were reported to have ever had malaria and 45% reported to have ever had diarrhoea. There was no statistically significant association between gender or level of education and malaria knowledge. Eighty six percent of respondents had received a free bed net during national campaigns and 61% slept under a bed net the night before the survey. Knowing mosquitoes to be the cause of malaria and receiving free bed net were significantly associated with sleeping under a bed net. There was no statistically significant association between drinking water source and malaria or diarrhoea. Conclusions Both malaria and diarrhoea were considered to be serious illnesses for adults and children by nearly all respondents. Receiving free bed nets and having correct knowledge about malaria were the greatest predictors of sleeping under a bed net. Insights from this detailed KAP survey—such as focusing on radio to transmit malaria prevention information and reinforcing free malaria treatments—can guide policy makers and practitioners who design and implement malaria control and prevention measures in Guinea.

Malaria is the top public health problem in the Republic of Guinea. In 2016, we conducted a cross-sectional household survey in Timbi-Touni, Guinea using community workers. The survey included respondent demographic characteristics, child health, child health promotion related to malaria knowledge, water and sanitation, and health services access. Majority of our respondents were women (89.41%) and had never been to school (71.18%). Slightly more than half the children were reported to have ever had malaria and 45% reported to have ever had diarrhea. We did not find any statistically significant association between gender or level of education and malaria knowledge. Eighty six percent of respondents had received a free bednet during national campaigns and 61% slept under a bednet the night before the survey. We found a statistically significant association between receiving information on malaria prevention and sleeping under a bednet. There was no statistically significant association between drinking water source and malaria or diarrhea. Both malaria and diarrhea were considered to be serious illnesses for adults and children by nearly all respondents. Insights from our detailed KAP survey can guide policy makers and practitioners who design and implement malaria control and prevention measures in Guinea.