Anemia and Micronutrient Status of Women of Childbearing Age and Children 6–59 Months in the Democratic Republic of the Congo

Abstract

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.

Micronutrient intake and prevalence of micronutrient inadequacy among women (15-49 y) and children (6-59 mo) in South Kivu and Kongo Central, Democratic Republic of the Congo (DRC)

“…However, the general conclusions are consistent with those from the biochemical results that show a moderate to high prevalence of zinc deficiency, in which more than half of women and a quarter of children had low serum zinc concentrations. (2)…”

“…A cross-sectional survey using the multiple pass 24-hour dietary recall (24HDR) interview method was conducted from August to October 2014 to assess usual dietary intake and estimate the prevalence of inadequacy for select nutrients in two contrasting provinces in the DRC, South Kivu and Kongo Central. This was part of a larger nutritional assessment survey in the two provinces, the biochemical results of which have been reported on in Harvey-Leeson et al(2) These two provinces were selected as they were politically stable at the time of data collection and captured the country’s diverse geographical landscape. The densely populated eastern province of South Kivu was selected for its high altitude, where most of the population lives approximately 1000 m above sea level.…”

“…The sampling method used for this study has been described in detail elsewhere. (2) Briefly, participants were selected using a three-stage probability proportionate to size (PPS) sampling method. During the first stage, only those health zones in closest proximity to biological sample processing centres in Bukavu and Kinshasa were included in the sampling frame to maintain the integrity of the blood samples collected concurrently with the 24 HDRs.…”

Comparison of four immunoassays to measure serum ferritin concentrations and iron deficiency prevalence among non-pregnant Cambodian women and Congolese children

“…This method-comparison study included data collected from baseline surveys in two trials: n = 420 non-pregnant women of reproductive age (18-45 year) from Prey Veng province, Cambodia, who were selected for inclusion in a larger trial evaluating the outcomes of an improved homestead food production and aquaculture project [17]; and n = 226 children (6-59 month) representatively sampled from South Kivu and Bas Congo provinces, Democratic Republic of the Congo (DRC), as part of a larger micronutrient survey [18]. Work was carried out in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki).…”

Predictors of anemia in women of reproductive age: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project

“…Multiple individual studies that have examined the determinants of anemia with the use of individual-level data on micronutrient and disease status have shown that the proportion of anemia that is attributable to iron deficiency is highly variable and that other risk factors may play more important roles in determining hemoglobin concentration and anemia (19, 20). …”