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Epidemiology Seminar: “Micronutrient Deficiencies in Africa – Where, Why, and the Associated Influence on Child Growth”
December 18, 2019 @ 12:00 pm - 1:00 pm
“Micronutrient Deficiencies in Africa – Where, Why, and the Associated Influence on Child Growth” will be presented by Djibril Ba, MPH, Research Data Management Specialist, Public Health Sciences, and Paddy Ssentongo, MD, MPH, Assistant Research Professor of Engineering Science and Mechanics.
Iron, iodine, and vitamin A deficiencies affect more than 2 billion people globally and are associated with increased risk of mortality and high rates of disability-adjusted life-years. Salt fortification with iodine and iron supplementation during pregnancy are recognized as cost-effective and feasible methods to prevent micronutrient deficiencies in pregnant women and adverse pregnancy outcomes in developing countries such as sub-Saharan Africa (SSA). There is a need for updated regional, sub-regional and country-specific epidemiological studies of micronutrient deficiencies in Africa to inform ongoing interventions.
In recent research, Ba and Ssentongo aimed to explore the prevalence, determinants and associated outcomes of micronutrient deficiencies in Africa using large population-based cross-sectional data. For these four studies, they included multiple SSA countries using the recent Demographic and Health Surveys that measured urinary iodine concentration (UIC) among women of childbearing age, iron supplementation among pregnant women, serum retinol-binding protein (a proxy biomarker for vitamin A in blood) and tested salt for iodine content. Multivariable Poisson and Logistic regression models were used to identify factors associated with iodine deficiency, adherence to iron supplementation and the association of vitamin A deficiency (VAD) and stunted growth failure in children.
The results showed that countries with the highest rate of non-iodized salt were Senegal (29.5 percent) followed by Tanzania (21.3 percent), Ethiopia (14.0 percent), Malawi (11.6 percent), and Angola (10.8 percent). The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was only 28.7 percent, ranging from 1.4 percent in Burundi to 73.0 percent in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95 percent CI: 22.36, 29.60] compared with no antenatal visits. In Tanzania, the study found that factors associated with iodine deficiency were: currently being pregnant (aPR) 1.20 [95 percent CI 1.01, 1.43], currently breastfeeding (aPR) 1.16 [95 percent CI 1.03, 1.31], consuming inadequate iodized salt (<15 PPM) (aPR) 1.80 [95 percent CI 1.60, 2.02]. In Uganda, the overall prevalence of VAD was 9 percent, and 35 percent in children with stunted growth failure. Children with VAD experienced 54 percent higher odds of stunted growth than those who did not (adjusted odds ratio [OR] 1.54; 95 percent Confidence Interval [CI] 1.15–2.05). The epidemiological implications of these findings are critical and could guide intervention strategies that are tailored to the need of the population.
Light refreshments will be provided.