Post-production Losses in Iodine Concentration of Salt Hamper the Control of Iodine Deficiency Disorders: A Case Study in Northern Ethiopia

Iodine is essential for good function of the thyroid, and its deficiency is of public-health importance in Ethiopia. Iodization of salt is an effective and sustainable strategy to prevent and control iodine deficiency in large populations. The effectiveness of salt-iodization programmes depends on the conservation of iodine concentration in salt at various stages of the supply-chain. The overall objective of the study was to assess the loss of iodine in salt from production to consumption and to estimate the proportion of adults, especially pregnant women, at risk of dietary iodine insufficiency. A cross-sectional study was conducted during February-April 2007 in northern Ethiopia. Iodine concentrations of salt samples from producers (n=41), retailers (n=7), and consumers (n=32) were determined using iodiometric titration. A risk assessment was conducted for dietary iodine insufficiency among adults, including pregnant women, using a semi-probabilistic approach. The concentration of iodine in the sampled salts decreased by 57% from the production site to the consumers. The assessment of exposure showed that adults in 63% (n=20) of the households, including 90% (n=29) with pregnant women, were at risk of insufficient iodine intake. A monitoring and evaluation system needs to be established to ensure adequate supply of iodine along the distribution chain. Special attention is needed for the retailers and consumers. At these levels, dissemination of information regarding proper storage and handling of iodized salt is necessary to address the reported loss of iodine from salt

Post-production losses in iodine concentration of salt hamper the control of iodine deficiency disorders: A case study in Northern Ethiopia

Iodine is essential for good function of the thyroid, and its deficiency is of public-health importance in Ethiopia. Iodization of salt is an effective and sustainable strategy to prevent and control iodine deficiency in large populations. The effectiveness of salt-iodization programmes depends on the conservation of io-dine concentration in salt at various stages of the supply-chain. The overall objective of the study was to assess the loss of iodine in salt from production to consumption and to estimate the proportion of adults, especially pregnant women, at risk of dietary iodine insufficiency. A cross-sectional study was conducted during February-April 2007 in northern Ethiopia. Iodine concentrations of salt samples from producers (n=41), retailers (n=7), and consumers (n=32) were determined using iodiometric titration. A risk assess-ment was conducted for dietary iodine insufficiency among adults, including pregnant women, using a semi-probabilistic approach. The concentration of iodine in the sampled salts decreased by 57% from the production site to the consumers. The assessment of exposure showed that adults in 63% (n=20) of the households, including 90% (n=29) with pregnant women, were at risk of insufficient iodine intake. A monitoring and evaluation system needs to be established to ensure adequate supply of iodine along the distribution chain. Special attention is needed for the retailers and consumers. At these levels, dissemina-tion of information regarding proper storage and handling of iodized salt is necessary to address the re-ported loss of iodine from salt

Comparison of urinary aflatoxin M1 and aflatoxin albumin adducts as biomarkers for assessing aflatoxin exposure in Tanzanian children

Purpose: To determine levels of urinary aflatoxin M1 (AFM1) in children and correlate the concentrations with previously reported aflatoxin albumin adduct (AF-alb) levels in these children. Materials and methods: Matched urine and blood samples were collected from 84 Tanzanian children aged 6–14 months old. From 31 children in one village (Kigwa), samples were collected at three time points six months apart. Samples were collected from 31 and 22 children from two different regions at the second time point only. Urinary AFM1 was measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit with a modified protocol to improve sensitivity. AF-alb was measured using an established ELISA method. Results: The relative ranking of the three villages for exposure to aflatoxin based on either AFM1 or AF-alb biomarker measurements was the same. In Kigwa village, both AFM1 and AF-alb levels were higher at six months post-harvest compared to baseline. However, at the next visit, the AFM1 levels dropped from a GM (interquartile range) of 71.0 (44.7, 112.6) at visit two to 49.3 (31.5, 77.3) pg/ml urine, whereas AF-alb levels increased from 47.3 (29.7, 75.2) to 52.7 (35.4, 78.3) pg/mg albumin between these two visits, reflecting the fact that AFM1 measures short-term exposure, whereas AF-alb measures longer term exposure. There was a correlation between AFB1 intake and AFM1 excretion (r= 0.442, p ≤ 0.001). Conclusions: Urinary AFM1 is a good biomarker for AFB1 exposure in Tanzanian children, reflecting geographical and temporal variations in exposure to this foodborne toxin

A Prospective Study of Growth and Biomarkers of Exposure to Aflatoxin and Fumonisin during Early Childhood in Tanzania

Background: Aflatoxin and fumonisin are toxic food contaminants. Knowledge about effects of their exposure and coexposure on child growth is inadequate. Objective: We investigated the association between child growth and aflatoxin and fumonisin exposure in Tanzania. Methods: A total of 166 children were recruited at 6–14 months of age and studied at recruitment, and at the 6th and 12th month following recruitment. Blood and urine samples were collected and analyzed for plasma aflatoxin–albumin adducts (AF-alb) using ELISA, and urinary fumonisin B1 (UFB1) using liquid chromatography–mass spectrometry, respectively. Anthropometric measurements were taken, and growth index z-scores were computed. Results: AF-alb geometric mean concentrations (95% CIs) were 4.7 (3.9, 5.6), 12.9 (9.9, 16.7), and 23.5 (19.9, 27.7) pg/mg albumin at recruitment, 6 months, and 12 months from recruitment, respectively. At these respective sampling times, geometric mean UFB1 concentrations (95% CI) were 313.9 (257.4, 382.9), 167.3 (135.4, 206.7), and 569.5 (464.5, 698.2) pg/mL urine, and the prevalence of stunted children was 44%, 55%, and 56%, respectively. UFB1 concentrations at recruitment were negatively associated with length-for-age z-scores (LAZ) at 6 months (p = 0.016) and at 12 months from recruitment (p = 0.014). The mean UFB1 of the three sampling times (at recruitment and at 6 and 12 months from recruitment) in each child was negatively associated with LAZ (p < 0.001) and length velocity (p = 0.004) at 12 months from recruitment. The negative association between AF-alb and child growth did not reach statistical significance. Conclusions: Exposure to fumonisin alone or coexposure with aflatoxins may contribute to child growth impairment

Household vegetable processing practices influencing occurrence of pesticide residues in ready‐to‐eat vegetables

This research article published by John Wiley & Sons, 2019Influence of vegetable processing on pesticide residues in ready‐to‐eat vegetables studied at the experimental level does not necessarily reflect actual situation at household level. This study assessed influence of household vegetable processing practices on pesticide residues in ready‐to‐eat vegetables at household level in Arusha, Tanzania. Data on vegetable handling practices were collected through observations and physical interviews in 70 households. Samples of raw and ready‐to‐eat vegetables were collected from the households for pesticide residues analysis. Detectable pesticide levels were found in 46% of raw and 14% of ready‐to‐eat vegetable samples. Pesticide residues detected were in the groups of organophosphates (22.8%), pyrethroids (14.3%), organochlorines (7.14%), benzoic acids (7.14%), and carbamates (5.71%). Unauthorized pesticides (dichlorvos, tetramethrin, and bendiocarb) and environmentally persistent pesticide (dieldrin) were found at levels above their respective maximum residue levels. Washing of vegetables twice or more (p = .01) or peeling (p = .008) was significantly associated with reduction of pesticide residues. There was a significant association between occurrence of pesticide residues in ready‐to‐eat vegetables and washing of minor ingredients with the water used to wash major ingredients (p = .001). Household practices of washing of vegetables with portable water followed with peeling can reduce pesticide residue levels significantly

Efficacy of Different Doses of Multiple Micronutrient Powder on Haemoglobin Concentration in Children Aged 6–59 Months in Arusha District

In Tanzania’s Arusha District, anaemia is a significant public health problem. Recently, home fortification with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be effective. However, it is a challenge for deprived families with low income to afford the daily sachet. The aim of this study was to compare the efficacy of different administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. This research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n=369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either five sachets (n=60), three sachets (n=80), two sachets (n=105), or one sachet (n=124) for six months; 310 children completed the study. Using the HemoCue technique, a finger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin levels. The effect of treatment on haemoglobin was assessed with analysis of covariates with Bonferroni post hoc to test group difference (p>0.05) from each other. At the end, haemoglobin levels were significantly higher in participants who received three or five sachets of micronutrient powder per week compared to those who received one or two micronutrient powder sachets per week (p<0.05). The prevalence of illnesses was reduced from 65% to 30.5% in all groups. This finding indicates that economically challenged families may opt for three times per week sachet administration rather than a more costly daily administration. This trial is registered with PACTR201607001693286

Factors Influencing Willingness to Pay for Multiple Micronutrient Powder (Virutubishi) Supplements for Young Children in Arusha, Tanzania

Research Article published by the Journal of Health & Medical Economics Vol.4, No.2:8, 2018Background: Multiple micronutrient powders have shown a positive effect on anaemia prevention in children 6-59 months. For the purposes of uptake and sustainability, we explored ‘‘willingness to pay’’ for these health products at the household level for potential of co-investment in multiple micronutrient powders. Methods: During the intervention (six months), household surveys were conducted once with mothers of children 6-59 months in the Arusha District regarding willingness to pay for the multiple micronutrient powders. Results: Results from the survey show that about 66% of the target mothers are willing to pay for multiple micronutrient powders required for feeding of children at 0.068$ per sachet. Willingness to pay was associated with higher paternal education, higher maternal age, and families which do not keep animals. Conclusion: The results findings help to know the market situation of nutritional products. This information is useful for health policy planners in assessing economic viability and sustainability of the distribution of multiple micronutrient powders to consumers to avert micronutrient deficiencies and their effects on young children

Prevalence and predictors of anemia among children under 5 years of age in Arusha District, Tanzania

Research Article publihed by Dove Press JournalAnemia is a global health problem affecting most developing countries. We examined the prevalence of anemia and its predictors among children under 5 years of age in Arusha District, Tanzania. Random sampling technique was used to identify 436 children aged 6–59 months. Anemia status was assessed by measuring hemoglobin concentration from blood sample obtained from a finger prick and HemoCue® Hb 201+ photometer. Demographic information and dietary intake data were collected using a standardized questionnaire. Anemia cut-off points were defined according to World Health Organization standards for children aged 6–59 months. Logistic regression using backward procedure was used to estimate odds ratios (ORs) at 95% confidence intervals (CIs). Prevalence rate of anemia among under-fives was found to be 84.6% (n=369). Multivariable logistic regression identified the following predictors of anemia; low birth weight (adjusted OR (AOR): 2.1, 95% CI: 1.1–3.8), not consuming meat (AOR: 6.4, 95% CI: 3.2–12.9), not consuming vegetables (AOR: 2.1, 95% CI: 1.1–4.1), drinking milk (AOR: 2.5, 95% CI: 1.1–5.2), and drinking tea (AOR: 4.5, 95% CI: 1.5–13.7). It was concluded that low birth weight and dietary factors (ie, low or nonconsumption of iron-rich foods like meat, vegetables, and fruits) were predictors of anemia among under-five children living in this rural setting. Community education on exclusive breastfeeding and introduction of complementary foods should be improved. Mothers and caretakers should be educated about nutrition, in general, as well as potential use of micronutrient powder to improve the nutritional quality of complementary foods