Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6–23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24–59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6–23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24–59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6–23 months (23% in SK; 20% in KC), and children 24–59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention.
Iron biofortified beans and carotenoid enriched cassava are proposed as a solution to combat iron and vitamin A deficiencies, respectively, in the Democratic Republic of Congo (DRC). To inform the need for biofortified foods, we conducted a survey in 2014 in two provinces of the DRC, South Kivu and Kongo Central. Unexpectedly, women of reproductive age (WRA; 15-49 y) and their children (6-59 m) had a low prevalence of biochemical iron and vitamin A deficiency, based on ferritin and retinol binding protein, respectively. To better understand the lack of biochemical deficiency of these nutrients, we examined the prevalence of inadequate intake for these and other select nutrients. Dietary intake was assessed using 24-hour recalls among 744 mother-child dyads. Repeat recalls on a non-consecutive day were conducted with a subsample of the study population to account for intra-individual variation and estimate usual intake. In WRA, the prevalence of inadequate iron intakes were 33% and 29% in South Kivu and Kongo Central, respecitvely. The prevalence of inadequate vitamin A intakes among WRA was low in South Kivu (18%) and negligible in Kongo Central (1%). Iron inadequacy was highest in infants (6-11 m) at 82% and 64% in South Kivu and
Iron biofortified beans and carotenoid enriched cassava are proposed as a solution to combat iron and vitamin A deficiencies, respectively, in the Democratic Republic of Congo (DRC). To inform the need for biofortified foods we conducted a survey in 2014, in two provinces of the DRC, South Kivu and Kongo Central. Unexpectedly, women of reproductive age (WRA; 15-49 y) and their children (6-59 m) had a low prevalence of biochemical iron and vitamin A deficiency, based on ferritin and retinol binding protein, respectively. However, to better understand the lack of biochemical deficiency of these nutrients we examined the prevalence of inadequate intake for these and other select nutrients. Dietary intake was assessed using 24-hour recalls (with repeats) among 744 mother-child dyads. In WRA the prevalence of inadequate iron intakes was 32% (10% bioavailability). The prevalence of inadequate vitamin A intakes was low in South Kivu (18%) and negligible in Kongo Central (1%). The prevalence of inadequate iron intake was 74% in infants (6-11 m) and ~22% in the older children (12-59 months). There was a high prevalence of inadequate zinc intake in women and children (i.e. 83% WRA) consistent with our findings of a high prevalence of low serum zinc in the same sample. Dietary data here corroborate the low prevalence of biochemical vitamin A deficiency but not iron. However, any change to the supply of red palm oil would dramatically reduce population vitamin A intakes, thus a carotenoid enriched cassava program may be beneficial as a safety net measure. Additionally, iron biofortified beans may be warranted given the high rates of dietary inadequacy and uncertainty around the validity of iron biomarkers. Crops biofortified with zinc also appear warranted. We caution that our findings cannot be extrapolated to the entire Congo where diverse agro-ecological landscape exist or when political and environmental shocks occur which challenge food production.
Community-based forest management (CBFM) is an approach that involves small-scale community owned and managed forestry that is drawing serious attention for its applicability to achieving sustainable forest practices. In this paper, I researched the question: What factors explain the success and failure of CBFM in developing countries?Thirty-four case studies of CBFM in 14 developing countries were reviewed and statistically analyzed. A total of 47 independent factors were found to significantly influence the outcome (success or failure) of these CBFM experiments, of which the most important determinants of success were: the comprehensiveness and objectives of the management plan, land tenure, ownership and property rights, types of support, participation (in particular that of women), perceptions (project confidence, perceived tangible benefits, social capitol, environmental concern, and equality between community members), agricultural and land management systems used (use of agroforestry techniques, rehabilitation of degraded lands), national community based forest management policy, community governance and law, socio-economic attributes, and the degree of decentralization. These factors were then used to develop steps to sustainable forestry success as a guide to the initiation and development of successful community based forest management in developing countries.
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