The potential of food fortification to add micronutrients in young children and women of reproductive age - findings from a cross-sectional survey in Abidjan, Côte d'Ivoire

Poor micronutrient intakes are a major contributing factor to the high burden of micronutrient deficiencies in Côte d'Ivoire. Large-scale food fortification is considered a cost-effective approach to deliver micronutrients, and fortification of salt (iodine), wheat flour (iron and folic acid), and vegetable oil (vitamin A) is mandatory in Côte d'Ivoire. A cross-sectional survey on households with at least one child 6-23 months was conducted to update coverage figures with adequately fortified food vehicles in Abidjan, the capital of and largest urban community in Côte d'Ivoire, and to evaluate whether additional iron and vitamin A intake is sufficient to bear the potential to reduce micronutrient malnutrition. Information on demographics and food consumption was collected, along with samples of salt and oil. Wheat flour was sampled from bakeries and retailers residing in the selected clusters. In Abidjan, 86% and 97% of salt and vegetable oil samples, respectively, were adequately fortified, while only 32% of wheat flour samples were adequately fortified, but all samples contained some added iron. There were no major differences in additional vitamin A and iron intake between poor and non-poor households. For vitamin A in oil, the additional percentage of the recommended nutrient intake was 27% and 40% for children 6-23 months and women of reproductive age, respectively, while for iron from wheat flour, only 13% and 19% could be covered. Compared to previous estimates, coverage has remained stable for salt and wheat flour, but improved for vegetable oil. Fortification of vegetable oil clearly provides a meaningful additional amount of vitamin A. This is not currently the case for iron, due to the low fortification levels. Iron levels in wheat flour should be increased and monitored, and additional vehicles should be explored to add iron to the Ivorian diet

ABCES ET EMPYEMES INTRACRANIENS CHEZ L’ENFANT OBSERVES A ABIDJAN (CÔTE D'IVOIRE) (CEREBRAL ABCESS AND INTRACRANIAL EMPYEMAS IN CHILDREN.)

BACKGROUND Abcess and empyemas are frequent intracranial lesions in children. OBJECTIVES : The authors report the clinicals, radiologicals bacteriologicals and therapeuticals aspects of these intracranial suppurations observed in Abidjan. METHOD A retrospective analysis has been led in the neurosurgical department of university teaching hospital of Yopougon on 5 years period (December' 93 to december' 98). That study were based on 34 clinical observations on patients between 7 months and 15 years of age. RESULTS The authors reported 34 cases of abscess and intracranial empyemas on children subdural empyemas cases represented 44,1 %, abcess 20,5 % and the two lesions were associated in 17,6 %. Bacteriological agents isolated on 12 patients were gram positif cocci (3 cases) heamophilus (2 cases) flora mixed (2 cases) and a combination of pseudomonas acinetobacter (1 cases). The predisposing factors were ENT diseases. CONCLUSION : Intracranial subdural empyemas are most common form of intracranial suppurations seen on child in our unit. This study can be considered as a speech for the defense of the use one cerebral abcess and intracranial empyemas surgical drainage via burrhole. The author stress the interest of eradication of primary source of the sepsis and the appropriate treatment of head trauma

ABCES ET EMPYEMES INTRACRANIENS CHEZ L’ENFANT OBSERVES A ABIDJAN (CÔTE D'IVOIRE) (CEREBRAL ABCESS AND INTRACRANIAL EMPYEMAS IN CHILDREN.)

BACKGROUND Abcess and empyemas are frequent intracranial lesions in children. OBJECTIVES : The authors report the clinicals, radiologicals bacteriologicals and therapeuticals aspects of these intracranial suppurations observed in Abidjan. METHOD A retrospective analysis has been led in the neurosurgical department of university teaching hospital of Yopougon on 5 years period (December' 93 to december' 98). That study were based on 34 clinical observations on patients between 7 months and 15 years of age. RESULTS The authors reported 34 cases of abscess and intracranial empyemas on children subdural empyemas cases represented 44,1 %, abcess 20,5 % and the two lesions were associated in 17,6 %. Bacteriological agents isolated on 12 patients were gram positif cocci (3 cases) heamophilus (2 cases) flora mixed (2 cases) and a combination of pseudomonas acinetobacter (1 cases). The predisposing factors were ENT diseases. CONCLUSION : Intracranial subdural empyemas are most common form of intracranial suppurations seen on child in our unit. This study can be considered as a speech for the defense of the use one cerebral abcess and intracranial empyemas surgical drainage via burrhole. The author stress the interest of eradication of primary source of the sepsis and the appropriate treatment of head trauma

Legally mandated fortification levels in Côte d’Ivoire for wheat flour, vegetable oil and salt.

<p>Legally mandated fortification levels in Côte d’Ivoire for wheat flour, vegetable oil and salt.</p

Additional Vitamin A and Iron Intake from Fortified Vegetable Oil and Wheat Flour for Children 6–23 Months of Age and Women of Reproductive Age, Disaggregated for Poor and Non-Poor Respondents, Abidjan, 2014.

<p>Additional Vitamin A and Iron Intake from Fortified Vegetable Oil and Wheat Flour for Children 6–23 Months of Age and Women of Reproductive Age, Disaggregated for Poor and Non-Poor Respondents, Abidjan, 2014.</p

Daily Oil and Wheat Flour Consumption Stratified by Population Group and MPI Score, Abidjan, 2014^a.

<p>Daily Oil and Wheat Flour Consumption Stratified by Population Group and MPI Score, Abidjan, 2014<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158552#t003fn001" target="_blank">^a</a>.</p

Household Coverage with Unfortified and Inadequately and Adequately Fortified Wheat Flour, Salt, and Vegetable Oil, Abidjan, 2014.

<p>“Adequately fortified” is defined according to the most recent national regulations [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158552#pone.0158552.ref015" target="_blank">15</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158552#pone.0158552.ref016" target="_blank">16</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158552#pone.0158552.ref018" target="_blank">18</a>]: > 30 mg iron/kg of flour as ferrous fumarate, > 30 mg iodine/kg salt as potassium iodate, and > 8 μg RE/g oil as retinyl palmitate.</p

Vitamin A and Iron Contribution from Fortified Vegetable Oil and Wheat Flour, Expressed as % of RNI, Stratified by Population Group and MPI Score, Abidjan, 2014^a.

<p>Vitamin A and Iron Contribution from Fortified Vegetable Oil and Wheat Flour, Expressed as % of RNI, Stratified by Population Group and MPI Score, Abidjan, 2014<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0158552#t004fn001" target="_blank">^a</a>.</p