Screening for Acute Childhood Malnutrition during the National Nutrition Week in Mali Increases Treatment Referrals

OBJECTIVE: To evaluate a pilot intervention designed to integrate mid-upper arm circumference (MUAC) screening for acute malnutrition into the semi-annual Child Nutrition Week (Semaine d'Intensification des Activités de Nutrition, or "SIAN") activities carried out in June 2008. DESIGN: A cross-sectional survey was conducted in Kolokani and Nara, two health districts in the Koulikoro region of Mali, 4-5 months after the SIAN, using a population-proportionate, multi-stage random sample of: 1) health centers, and 2) households in communities linked to each of the selected health centers. Caregivers of 1543 children who were 6-59 months of age at the time of the SIAN, 17 community-based volunteers and 45 health center staff members were interviewed. RESULTS: A total of 1278 children 6-59 months (83% of those studied) reportedly participated in SIAN. Of the participating children, 1258 received vitamin A (98% of SIAN participants; 82% of all eligible children), 945 received anti-helminth tablets (84% of participants; 71% of eligibles), and 669 were screened for acute malnutrition (52% of participants; 43% of eligibles). 186 of the children screened (27%) were reportedly identified as acutely malnourished. SIAN screening covered a significantly greater proportion of children than were examined in both community-based (22% of children) and health center-based screening activities (5% of children) combined during the 4-5 months after the SIAN (P<0.0001). In general, community volunteers and health personnel positively evaluated their experience adding MUAC screening to SIAN. CONCLUSION: Integrating MUAC screening for acute malnutrition in SIAN permits the assessment of a large number of children for acute malnutrition, and should be continued

Aflatoxin B1 levels in groundnut products from local markets in Zambia

In Zambia, groundnut products (milled groundnut powder, groundnut kernels) are mostly sold in under-regulated markets. Coupled with the lack of quality enforcement in such markets, consumers may be at risk to aflatoxin exposure. However, the level of aflatoxin contamination in these products is not known. Compared to groundnut kernels, milled groundnut powder obscures visual indicators of aflatoxin contamination in groundnuts such as moldiness, discoloration, insect damage or kernel damage. A survey was therefore conducted from 2012 to 2014, to estimate and compare aflatoxin levels in these products (n = 202), purchased from markets in important groundnut growing districts and in urban areas. Samples of whole groundnut kernels (n = 163) and milled groundnut powder (n = 39) were analysed for aflatoxin B1 (AFB1) by competitive enzyme-linked immunosorbent assay (cELISA). Results showed substantial AFB1 contamination levels in both types of groundnut products with maximum AFB1 levels of 11,100 μg/kg (groundnut kernels) and 3000 μg/kg (milled groundnut powder). However, paired t test analysis showed that AFB1 contamination levels in milled groundnut powder were not always significantly higher (P > 0.05) than those in groundnut kernels. Even for products from the same vendor, AFB1 levels were not consistently higher in milled groundnut powder than in whole groundnut kernels. This suggests that vendors do not systematically sort out whole groundnut kernels of visually poor quality for milling. However, the overall contamination levels of groundnut products with AFB1 were found to be alarmingly high in all years and locations. Therefore, solutions are needed to reduce aflatoxin levels in such under-regulated markets

Efficacité de la spiruline comparée aux méthodes classiques dans la lutte contre la malnutrition infantile au Mali

Current context: Malnutrition in the world is currently at the origin of 54% of the deaths of children below äns (1,2). In Mali, according to the EDSM IV, 15% of the children suffer from emaciation and 27% from the children, of ponderal insufficiency. Drank: The goal is to determine the effectiveness of a nutritional recovery containing spiruline as a multi-vitamin natural supplement and multi-microéléments in infantile flours at children from 0 to 59 months malnutris in Sabalibougou, and to compare it with that of fish and flours infantile. Materials and methods: We had 153 old children from 6 to 59 months chosen in 3 centers of health: on the level of ASACO-Sab1 63 children, ASACOSAB 2 62 children, ASACOSAB 3 68 children. The spiruline came from the unit from Safo, and the infantile flours of the UCODAL (simple enriched flour and flour enriched with fish). The protocols were as follows: enriched flour SINBA and Spiruline, enriched flour SINBA, flour enriched with the fish (silure) with 5%. The study lasted 9 weeks. Results: Our study confirmed the effectiveness of the spiruline in the flour compared with the protocols flour alone and flour-fish, in the assumption of responsibility of the severe stages of emaciation and ponderal insufficiency. The spiruline manages to change the severe statute into moderate statute. Concerning anaemia, a favorable evolution is noted with the three protocols. Conclusion: We obtained a weight gain of 136 g per week and a lengthening of 0,537 cm in two months. The improvement of the feeble statute of the children recorded was confirmed independent of the protocol, the age bracket and the sex by the test of Khi-deux. We noted that the mode flour-spiruline is most effective in the assumption of responsibility of the severe states of emaciation with a coefficient of reduction of 7.13, and also of the ponderal insufficiency with a factor of reduction equal to 4,64.Contexte actuel : La malnutrition dans le monde est actuellement à l’origine de près de 54% des décès d’enfants en dessous de 5ans (1,2). Au Mali, d’après l’EDSM IV, 15% des enfants souffrent d’émaciation et 27% des enfants, d’insuffisance pondérale. But : Le but est de déterminer l’efficacité d’une récupération nutritionnelle à base de spiruline en tant que supplément naturel multi-vitaminique et multi-microéléments dans des farines infantiles chez des enfants de 0 à 59 mois malnutris à Sabalibougou, et de la comparer à celle du poisson et des farines infantiles. Matériels et méthodes : Nous avions 153 enfants âgés de 6 à 59 mois choisis dans 3 centres de santé : au niveau de l’ASACO-Sab1 63 enfants, ASACOSAB2 62 enfants, ASACOSAB3 68 enfants. La spiruline provenait de l’unité de Safo, et le farines infantiles de l’UCODAL (farine enrichie simple et farine enrichie au poisson). Les protocoles étaient les suivants : de la farine enrichie SINBA et Spiruline, farine enrichie SINBA, farine enrichie au poisson (silure) à 5%. L’étude a duré 9 semaines. Résultats : Notre étude a confirmé l’efficacité de la spiruline dans la farine comparée aux protocoles farine seule et farine-poisson, dans la prise en charge des stades sévères d’émaciation et d’insuffisance pondérale. La spiruline parvient à faire changer le statut sévère en statut modéré. Concernant l’anémie, une évolution favorable est constatée avec les trois protocoles. Conclusion : Nous avons obtenu un gain de poids de 136 g par semaine et un allongement de 0,537 cm en deux mois. L’amélioration du statut anémique des enfants enregistrée a été confirmée indépendante du protocole, de la tranche d’âge et du sexe par le test du Khi-deux. Nous avons constaté que le régime farine-spiruline est le plus efficace dans la prise en charge des états sévères d’émaciation avec un coefficient de réduction de 7.13, et aussi de l’insuffisance pondérale avec un facteur de réduction égal à 4,64