Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population

Abstract

Objective: To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification. Design: Pre-and post-intervention study using a longitudinal cohort. Setting: Nangweshi refugee camp, Zambia. Subjects: Two hundred and twelve adolescents (10-19 years), 157 children (6-59 months) and 118 women (20-49 years) were selected at random by household survey in July 2003 and followed up after 12 months. Results: Maize grain was milled and fortified in two custom-designed mills installed at a central location in the camp and a daily ration of 400 g per person was distributed twice monthly to households as part of the routine food aid ration. During the intervention period mean Hb increased in children (0?87 g/dl; P , 0?001) and adolescents (0?24 g/dl; P 5 0?043) but did not increase in women. Anaemia decreased in children by 23?4 % (P , 0?001) but there was no significant change in adolescents or women. Serum transferrin receptor (log 10 -transformed) decreased by 20?082 mg/ml (P 5 0?036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (28?5 %; P 5 0?079). In adolescents, serum retinol increased by 0?16 mmol/l (P , 0?001) and vitamin A deficiency decreased by 26?1 % (P , 0?001).

Micronutrient fortification of food and its impact on woman and child health: a systematic review

“…Of these, 121 [25-145] studies were on infants and children and 79 [146-224] were on women, while one study had both women and children as their study population [33] (Figure 2). Furthermore 125 [25-28,30,32-39,41-44,47,48,51,53],[54,56,59,60,62,63,65-73,75-77],[81-83,85,86,88-90,92,93,95-104,107-109],[111-117,119-127,129,130,132-136,139-144,223,225-228] of these trials were RCTs; the rest were quasi-experimental [46,55,61,74,78,87,91] and before-after studies [29,31,40,45,49,50,52,57],[58,79,80,84,94,95,105,131],[137,138,149,150,153,157,159-169,172],[174,177,181,183-186,189-191,193,195-…”

“…A total of 34 studies were identified that reported outcomes on children [36-38,43,46,47,50,61-64],[67-69,71-76,82,86,87,92,93,98],[102,105,115,117,118,121,122,130]. Three of these were before-after studies and the rest were RCTs and quasi-experimental studies.…”

Impact of nutrition interventions on pediatric mortality and nutrition outcomes in humanitarian emergencies: A systematic review

“…Perhaps more importantly, studies differed in their definition of what constituted ‘recovery’ from malnutrition . While similar definitions of anaemia were used, some studies assessed ‘any’ anaemia and some examined severe, moderate and mild anaemia, with a subset of authors stratifying by age . This points towards a need for consensus on the definition of ‘anaemia’ stratified by age groups and of ‘recovery rate’ stratified for mild‐to‐moderate and severe malnutrition, to facilitate generalisability and comparability of future studies.…”

Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis

“…The introduction of improved CSB (i.e. Super Cereal) to the general ration in all five camps during 2010–2011 may also have contributed to reductions in anaemia [49]. Unfortunately, despite the best efforts of the researchers it was not possible to confirm the exact implementation dates for these activities, nor to what extent a combination of these interventions were consistently implemented over a specific time period.…”