Comparison of the Effects of Supplemental Red Palm Oil and Sunflower oil on Maternal Vitamin A Status.

Conflicting results have been reported on the ability of dietary carotenoids to improve vitamin A status in lactating women. Red palm oil is one of the richest dietary sources of beta-carotene. We aimed to determine the efficacy of red palm oil in increasing retinol and provitamin A status in pregnant and lactating women. Ninety rural, pregnant Tanzanian women from 3 randomly selected villages were recruited during their third trimester to participate in 3 dietary intervention groups: a control group, who were encouraged to maintain the traditional practice of eating staples with dark-green leafy vegetables, and 2 study groups, who were given either sunflower or red palm oil for use in household food preparations. The intervention lasted 6 mo. Plasma samples were collected at the third trimester and 1 and 3 mo postpartum, and breast-milk samples were collected 1 and 3 mo postpartum. Supplementation with red palm oil, which is rich in provitamin A, increased alpha- and beta-carotene concentrations significantly (P < 0.001) in both plasma and breast milk. Plasma retinol concentrations were similar in all dietary groups. Breast-milk retinol concentrations tended to decrease from 1 to 3 mo postpartum in the control group, but were maintained in both oil groups. The difference in change in breast-milk retinol concentration between the red palm oil group and the control group was significant (P = 0.041). Consumption of red palm oil increases concentrations of alpha- and beta-carotene in both breast milk and serum and maintains breast-milk retinol concentrations. Sunflower oil consumption seems to conserve breast-milk retinol similarly to consumption of red palm oil. Breast-milk retinol might be maintained through increased dietary intake of these vegetable oils and use of mild cooking preparation methods (such as the addition of oil at the end of cooking and avoidance of frying)

Out-of-Pocket Costs and Other Determinants of Access to Healthcare for Children with Febrile Illnesses: A Case-Control Study in Rural Tanzania.

To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania. A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5. Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness). Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs.$0.90, p<0.0001). Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs.$4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52), p<0.0001). In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%). The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private cost

Lipid-soluble Vitamins A, D, and E in HIV-Infected Pregnant women in Tanzania.

There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (<0.7 micromol/l), vitamin D (<80 nmol/l) and vitamin E (<9.7 micromol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin <85 g/l; P<0.01), plasma vitamin E (P=0.02), selenium (P=0.01) and vitamin D (P=0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P=0.01). The correlates of low vitamin D status were CD8 cell count (P=0.01), high ESR (ESR >81 mm/h; P<0.01), gestational age at enrollment (nonlinear; P=0.03) and plasma vitamins A (P=0.02) and E (P=0.01). For low vitamin E status, the correlates were money spent on food per household per day (P<0.01), plasma vitamin A concentration (nonlinear; P<0.01) and a gestational age <16 weeks at enrollment (P<0.01). Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions

Ionomic Variation Characterization In African Leafy Vegetables For Micronutrients Using Xrf And Hplc

Beside the phytochemical, ionomic fingerprinting represents the inorganic trace element composition of the cellular and organismal component. High-throughput elemental analysis technologies, such as X-Ray Fluorescence (XRF), are applied to ionomic analysis whereas phyto-chemical analyses tend to be in vitro . Both could contribute to: (a) insights on ionome-phytochem micronutrient composition; (b) genetic diversity variant discrimination among accessions to allow simple grouping; (c) core and/or reserve collections rationalization; (d) integration of bioinformatic and genetic tools; and (e) micronutrient-dense varietal improvement and/or cropping decisions. First, variant discrimination was appraised on individual element criterion (e.g. K or Ca or Fe or Zn). Second, on a multiple element (K & Ca & Fe & Zn) condition upon which nutrahealth-implied ionomic variant conditions were rationalized as: (a) Core &apos;exceptional&apos; grade collections scored between E8 and E10; (b) Core &apos;Medium&apos; grades (M5-M7); and (c) &apos;Least&apos; exceptional (Ll-L4) scored and regarded as reserve collections. Objectives were to: (1) Investigate a phyotchem background among the selected African Leafy Vegetables (ALVs) for coupling with ionome grading; (2) Assess variation among accessions based on single element criterion; (3) Characterize cumulative nutrahealth-implied ionomic variation among ALVs. Eleven ALV accessions were raised from seed at the University of Nairobi Greenhouse (2006) and leafy parts harvested. XRF was carried out at the Institute of Nuclear Science and Technology, University of Nairobi. High Performance Liquid Chromatographic (HPLC) analyses were done at the Tanzania Food and Nutritional Centre. Highly significant density variation (p≤0.001) among accessions due to Lutein and β-carotene suggested the phytochem effectiveness for variant discrimination accounting for 0.79 and 0.87 of (R2) variation. The single element K discriminator basis was highly significant (p<001) relative to the other elements but shyly corrected with only Fe. Latter&apos;s discrimination activity, however, correlated with 3 elements as thus: Mn&apos;s (r=0.64; p≤ .001); Ca&apos;s (r=0.51; p≤ .003); and leaf K&apos;s (r= 0.35 at p≤ 0.05). Leaf Ca&apos;s also correlated with three: with Mn&apos;s (0.52; p≤ .003); Fe&apos;s (already shown); and Zn (r=.39; p<.03). Data suggest that ionomic variation discriminator ability on Fe & Ca single element selection basis may &apos;walk&apos; with others. Conclusions are: (1) that for primary data mining, XRF can be utilized as the first course of action for large-sized ionomic screening which can be rationalized into Core and Reserve collections to precede phytochem screening for utilization and/or conservation

Improved Solar Drying of Vitamin A-rich Foods by Women?s Groups in the Singida District of Tanzania

Working with partners in Ethiopia, Kenya, Peru, Tanzania, and Thailand, ICRW undertook a series of studies to explore how to increase intake of iron, vitamin A and iodine by combining women's productive and reproductive roles. This report summarizes the findings from the intervention research project implemented from 1995-98 in Tanzania. The focus of the study was to promote the adoption of improved home-based solar dryers as a means to enhance nutritional quality of vitamin A-rich foods and consumption of those foods by young children