Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Côte d'Ivoire

Abstract Objective To determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15-49 years; WRA) and children aged 6-59 months living in Côte d'Ivoire. Design Anthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition. Setting Data were from a nationally representative survey conducted in Côte d'Ivoire in 2007. Subjects A sample of 768 WRA and 717 children aged 6-59 months was analysed. Results Overall, 74·9 % of children and 50·2 % of WRA were anaemic; 39·5 % of the children were stunted, 28·1 % underweight and 12·8 % wasted, while 7·4 % of WRA had BMI < 18·5 kg/m2. In general, there were more stunted and underweight children and thin WRA in rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8·2 g/l and 6·5 g/l, respectively (13·9 % and 19·8 % difference in anaemia, respectively; P < 0·001), and Z-scores and BMI were significantly better in the wealthiest quintile (P < 0·001). Conclusions The poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession scor

Prevalence and public health relevance of micronutrient deficiencies and undernutrition in pre-school children and women of reproductive age in Côte d'Ivoire, West Africa

Abstract Objective To provide nationally representative data on the prevalence of anaemia, vitamin A and Fe deficiencies among pre-school age children (pre-SAC) and non-pregnant women of reproductive age (WRA), and on vitamin B12 and folate deficiencies in WRA, and the influence of inflammation on their interpretation. Design A cross-sectional survey to measure anthropometry, malaria parasitaemia and micronutrient status. Specifically, blood samples were analysed for Hb, plasma ferritin, soluble transferrin receptors, C-reactive protein, α1-acid glycoprotein, retinol-binding protein, vitamin B12 and folate. Setting Côte d'Ivoire in 2007. Subjects Nine hundred and twenty-eight WRA and 879 pre-SAC. Results In WRA, prevalence of Plasmodium parasitaemia (5 %) was low, but inflammation (34 %) was higher. Anaemia was a severe public health problem and prevalence differed by residency and eco-region. Inflammation-adjusted Fe deficiency was highest in urban areas (20 %). Nationally, folate deficiency was 86 %, higher in urban areas and varied by eco-region. Prevalence of vitamin B12 deficiency was low but higher in the rural areas and the north. Inflammation-adjusted vitamin A deficiency was very low (1 %). In pre-SAC, prevalence of inflammation (67 %) and Plasmodium parasites (25 %) was high; the latter was associated with poverty, rural residency and higher ferritin concentrations. Anaemia was classified as a severe public health problem (72 %), and was higher in rural areas (76 %) and the north (87 %). A quarter of pre-SAC suffered from vitamin A deficiency (inflammation-adjusted) and prevalence of undernutrition was high. Conclusions Prevalence of inflammation, Plasmodium parasitaemia and micronutrient deficiencies were high in Côte d'Ivoire, particularly in pre-SAC. Nutritional interventions should be accompanied by strategies to reduce exposure to infection

Quality of normal delivery care in Côte d&apos;Ivoire

The aim of this study was to assess the quality of normal delivery care in Côte d&apos;Ivoire. A total of 229 women were included in a cross-sectional study conducted in four urban maternity wards between 2002 and 2003. Observation checklists and exit-interviews were used to examine various dimensions of care. The results showed that the overall quality of care was poor, despite most women giving birth with a professional midwife. A vaginal examination was performed systematically at admission but blood pressure was measured in less than half of the women. The partograph was completed during labour in only 5% of cases. Episiotomy and uterine revision rates were high at 24% and 32%, respectively. There was a lack of universal hygiene precautions and women received little support during labour. Our results question the quality of labour, delivery and post-partum care by skilled attendants in Côte d&apos;Ivoire.Qualité du service de l&apos;accouchement normal en Côte-d&apos;Ivoire Cette étude avait pour but d&apos;évaluer la qualité du service de l&apos;accouchement normal en Côte-d&apos;Ivoire. Au total, 229 femmes ont fait partie de cette étude transversale qui a été menée dans quatre salles d&apos;accouchement urbaines entre 2002 et 2003. On s&apos;est servi des listes de contrôle de l&apos;observation et les interviews de sortie pour examiner des dimensions différentes du service. Les résultats ont montré que dans l&apos;ensemble la qualité du service est médiocre, malgré le fait que la plupart des femmes accouchent avec l&apos;assistance d&apos;une sage-femme professionnelle. On a effectué systématiquement un examen vaginal au moment de l&apos;admission mais nous n&apos;avons mesuré la pression artérielle que chez moins d&apos;une moitié des femmes. La partagraphe n&apos;a été complétée pendant le travail que chez 5% des cas. Et les taux de l&apos;épisiotomie et de la révision de l&apos;utérin étaient élevés, s&apos;élevant jusqu&apos;à 24% et 32%, respecitvement. On a remarqué un manque de précautions d&apos;hygiène universelle et les femmes n&apos;ont reçu que très peu de soutien pendant le travail. Nos résultats mettent en question la qualité des services du travail et du soin du post-partum par les auxillaires habiletés en Côte d&apos;Ivoire

Prevalence and public health relevance of micronutrient deficiencies and undernutrition in pre-school children and women of reproductive age in Côte d'Ivoire, West Africa

ISSN:1368-9800ISSN:1475-272