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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

Seal, Andrew ; Kafwembe, Emmanuel ; Kassim, Ismail AR ; Hong, Mei ; Wesley, Annie ; Wood, John ; Abdalla, Fathia ; van den Briel, Tina

In: Public Health Nutrition, 2008, vol. 11, no. 7, p. 720-728

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    Titre
    • 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
    Auteur
    • Seal, Andrew. Centre for International Health and Development, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • Kafwembe, Emmanuel. Tropical Disease Research Centre, Ndola, Zambia
    • Kassim, Ismail AR. Centre for International Health and Development, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • Hong, Mei. Centre for International Health and Development, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • Wesley, Annie. Micronutrient Initiative, Ottawa, Canada
    • Wood, John. World Food Programme, Rome, Italy
    • Abdalla, Fathia. United Nations High Commissioner for Refugees, Geneva, Switzerland
    • van den Briel, Tina. World Food Programme, Rome, Italy
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Public Health Nutrition, 2008, vol. 11, no. 7, p. 720-728. Cambridge University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:289206
    Summary
    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 = 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 (log10-transformed) decreased by −0·082 μg/ml (P = 0·036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (−8·5 %; P = 0·079). In adolescents, serum retinol increased by 0·16 μmol/l (P < 0·001) and vitamin A deficiency decreased by 26·1 % (P < 0·001). Conclusions The introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents. Centralised, camp-level milling and fortification of maize meal is a feasible and pertinent intervention in food aid operations