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  1. Article ; Online: Total Liver Vitamin A Reserves, Determined With 13C2-Retinol Isotope Dilution, are Similar Among Tanzanian Preschool Children in Areas With Low and High Vitamin A Exposure.

    Urio, Elisaphinate M / Tanumihardjo, Sherry A / Fweja, Leonard W / Ndossi, Godwin D

    The Journal of nutrition

    2023  Volume 152, Issue 12, Page(s) 2699–2707

    Abstract: Background: In Tanzania, some districts have single vitamin A (VA) interventions and others have multiple interventions. There is limited information on total liver VA reserves (TLRs) among preschool children (PSC) in Tanzania.: Objectives: We ... ...

    Abstract Background: In Tanzania, some districts have single vitamin A (VA) interventions and others have multiple interventions. There is limited information on total liver VA reserves (TLRs) among preschool children (PSC) in Tanzania.
    Objectives: We assessed total body VA stores (TBSs) and TLRs among PSC living in 2 districts with low and high exposures to VA interventions using 13C-retinol isotope dilution.
    Methods: A cross-sectional, health facility-based study was conducted in 2 districts with access to VA supplementation only (low exposure to VA interventions) or multiple interventions (high exposure to VA interventions) to determine TLRs in 120 PSC aged 36-59 months. A questionnaire was used to collect data. Height and weight were measured, and the prevalence of undernutrition was based on z-scores. Blood samples were collected for measurement of TBSs, TLRs, retinol, biomarkers of infection and inflammation, and hemoglobin. 13C2-retinyl acetate (1.0 μmol) was administered to each child after blood collection, and the second sample was taken 14 days later. Serum was analyzed with HPLC and gas chromatography-combustion-isotope ratio mass spectrometry. Mann-Whitney U test was used to compare medians of nonnormally distributed variables. Pearson χ2 test was used to assess associations between 2 categorical variables.
    Results: Median TBSs differed between PSC from low-exposure (196 μmol; IQR, 120 μmol) and high-exposure (231 μmol; IQR, 162 μmol) intervention areas (P = 0.015). Median TLRs were 0.23 μmol/g liver (IQR, 0.14 μmol/g liver) and 0.26 μmol/g liver (IQR, 0.16 μmol/g liver) from low- and high-exposure areas, respectively, which did not significantly differ (P = 0.12). Prevalences of VA deficiency (VAD; ≤0.1 μmol/g liver) were 6.3% and 1.7% for PSC from low- and high-exposure areas, respectively. There was no significant difference in VAD (P = 0.25). No child had hypervitaminosis A (≥1.0 μmol/g liver).
    Conclusions: TLRs in Tanzanian PSC from 2 districts did not differ between low and high exposures to VA interventions. The majority had adequate VA stores. VAD in the study area presented a mild public health problem.
    MeSH term(s) Humans ; Child, Preschool ; Vitamin A ; Tanzania/epidemiology ; Cross-Sectional Studies ; Vitamin A Deficiency/epidemiology ; Liver ; Carbon Isotopes
    Chemical Substances Vitamin A (11103-57-4) ; Carbon-13 (FDJ0A8596D) ; Carbon Isotopes
    Language English
    Publishing date 2023-03-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 218373-0
    ISSN 1541-6100 ; 0022-3166
    ISSN (online) 1541-6100
    ISSN 0022-3166
    DOI 10.1093/jn/nxac227
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    Hoffman Steven J / Guindon G Emmanuel / Lavis John N / Ndossi Godwin D / Osei Eric JA / Sidibe Mintou / Boupha Boungnong

    Malaria Journal, Vol 10, Iss 1, p

    2011  Volume 363

    Abstract: Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications ... ...

    Abstract Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI 1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access to the internet (OR 1.52, 95% CI 1.08-2.14). Conclusions Improving healthcare providers' knowledge and practices is an untapped opportunity for expanding ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap between what is known from research evidence and the knowledge and practices of healthcare providers. Training on acquiring systematic reviews and facilitating internet access may be particularly helpful.
    Keywords Arctic medicine. Tropical medicine ; RC955-962 ; Infectious and parasitic diseases ; RC109-216
    Subject code 360
    Language English
    Publishing date 2011-12-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Audio / Video: Effect of grain pre-treatment on different extractable phenolic groups in cereals and legumes commonly consumed in Tanzania

    Towo, Elifatio E / Svanberg, Ulf / Ndossi, Godwin D

    Journal of the science of food and agriculture. 2003 July, v. 83, no. 9

    2003  

    Abstract: Extractable phenolic compounds, classified as total phenolics, resorcinols, catechols and galloyls, were determined in cereals and legume food grains commonly consumed in Tanzania, using various colorimetric methods. Grain samples of red sorghum (udo), ... ...

    Abstract Extractable phenolic compounds, classified as total phenolics, resorcinols, catechols and galloyls, were determined in cereals and legume food grains commonly consumed in Tanzania, using various colorimetric methods. Grain samples of red sorghum (udo), finger millet, cowpea, mung bean and brown kidney bean were further processed-soaked in water at different pHs, germinated, cooked or dehulled (legumes only)-and the effect on extractable phenolics was analysed. In untreated grains, total phenolics ranged from 0.9 to 33.7, catechols from 0.8 to 13.5 and resorcinols from 0.2 to 11 mg catechin equivalents (CE) g(-1). Galloyls (tannic acid equivalents, TAE) were found in negligible amounts in most grains, but in appreciable amounts in red sorghum (5.5 mg g(-1)). Processing of grains led to variable effects on the extractable phenolics. Soaking the grains significantly (p < 0.05) reduced the amount of total extractable phenolics in red sorghum, finger millet and cowpea, with alkali and acidic media being more effective. Water soaking had no effect on total extractable phenolics in mung bean and water, while alkali and acidic soaking had no effect on total extractable phenolics in brown kidney bean. Extractable catechols and resorcinols were affected by soaking in a similar pattern to total extractable phenolics. Germination reduced total extractable phenolics, catechols and resorcinols in all samples, except for catechols in mung bean. Cooking (boiling of grains) was more effective in reducing total extractable phenolics in cereals than germination and water soaking, while dehulling was the most effective method for reducing total extractable phenolics in legumes (p < 0.01).
    Keywords cooking ; cowpeas ; food grains ; germination ; hulling ; kidney beans ; millets ; mung beans ; pH ; pretreatment ; resorcinols ; soaking ; tannins ; Tanzania
    Language English
    Dates of publication 2003-07
    Size p. 980-986.
    Document type Article ; Audio / Video
    ZDB-ID 184116-6
    ISSN 1097-0010 ; 0022-5142
    ISSN (online) 1097-0010
    ISSN 0022-5142
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: Bridging the gaps among research, policy and practice in ten low- and middle-income countries

    Guindon G Emmanuel / Lavis John N / Cameron David / Akhtar Tasleem / Becerra Posada Francisco / Ndossi Godwin D / Boupha Boungnong

    Health Research Policy and Systems, Vol 8, Iss 1, p

    Development and testing of a questionnaire for researchers

    2010  Volume 4

    Abstract: Abstract Background A questionnaire could assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. No questionnaire focused on researchers' engagement in ...

    Abstract Abstract Background A questionnaire could assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. No questionnaire focused on researchers' engagement in bridging activities related to high-priority topics (or the potential correlates of their engagement) has been developed and tested in a range of low- and middle-income countries (LMICs). Methods Country teams from ten LMICs (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal, and Tanzania) participated in the development and testing of a questionnaire. To assess reliability we calculated the internal consistency of items within each of the ten conceptual domains related to bridging activities (specifically Cronbach's alpha). To assess face and content validity we convened several teleconferences and a workshop. To assess construct validity we calculated the correlation between scales and counts (i.e., criterion measures) for the three countries that employed both and we calculated the correlation between different but theoretically related (i.e., convergent) measures for all countries. Results Internal consistency (Cronbach's alpha) for sets of related items was very high, ranging from 0.89 (0.86-0.91) to 0.96 (0.95-0.97), suggesting some item redundancy. Both face and content validity were determined to be high. Assessments of construct validity using criterion-related measures showed statistically significant associations for related measures (with gammas ranging from 0.36 to 0.73). Assessments using convergent measures also showed significant associations (with gammas ranging from 0.30 to 0.50). Conclusions While no direct comparison can be made to a comparable questionnaire, our findings do suggest a number of strengths of the questionnaire but also the need to reduce item redundancy and to test its capacity to monitor changes over time.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 710
    Language English
    Publishing date 2010-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

    Hoffman, Steven J / Guindon, G Emmanuel / Lavis, John N / Ndossi, Godwin D / Osei, Eric J A / Sidibe, Mintou Fall / Boupha, Boungnong

    Malaria journal

    2011  Volume 10, Page(s) 363

    Abstract: Background: Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which ...

    Abstract Background: Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs).
    Methods: This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics.
    Results: The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI 1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access to the internet (OR 1.52, 95% CI 1.08-2.14).
    Conclusions: Improving healthcare providers' knowledge and practices is an untapped opportunity for expanding ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap between what is known from research evidence and the knowledge and practices of healthcare providers. Training on acquiring systematic reviews and facilitating internet access may be particularly helpful.
    MeSH term(s) Adult ; Africa/epidemiology ; Attitude of Health Personnel ; Female ; Health Personnel ; Humans ; Insecticide-Treated Bednets/statistics & numerical data ; Malaria/epidemiology ; Malaria/prevention & control ; Male ; Middle Aged ; Mosquito Control/methods ; Professional Competence/statistics & numerical data ; Surveys and Questionnaires
    Language English
    Publishing date 2011-12-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2091229-8
    ISSN 1475-2875 ; 1475-2875
    ISSN (online) 1475-2875
    ISSN 1475-2875
    DOI 10.1186/1475-2875-10-363
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of a questionnaire for researchers.

    Cameron, David / Lavis, John N / Guindon, G Emmanuel / Akhtar, Tasleem / Becerra Posada, Francisco / Ndossi, Godwin D / Boupha, Boungnong

    Health research policy and systems

    2010  Volume 8, Issue 1, Page(s) 4

    Abstract: Background: A questionnaire could assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. No questionnaire focused on researchers' engagement in ... ...

    Abstract Background: A questionnaire could assist researchers, policymakers, and healthcare providers to describe and monitor changes in efforts to bridge the gaps among research, policy and practice. No questionnaire focused on researchers' engagement in bridging activities related to high-priority topics (or the potential correlates of their engagement) has been developed and tested in a range of low- and middle-income countries (LMICs).
    Methods: Country teams from ten LMICs (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal, and Tanzania) participated in the development and testing of a questionnaire. To assess reliability we calculated the internal consistency of items within each of the ten conceptual domains related to bridging activities (specifically Cronbach's alpha). To assess face and content validity we convened several teleconferences and a workshop. To assess construct validity we calculated the correlation between scales and counts (i.e., criterion measures) for the three countries that employed both and we calculated the correlation between different but theoretically related (i.e., convergent) measures for all countries.
    Results: Internal consistency (Cronbach's alpha) for sets of related items was very high, ranging from 0.89 (0.86-0.91) to 0.96 (0.95-0.97), suggesting some item redundancy. Both face and content validity were determined to be high. Assessments of construct validity using criterion-related measures showed statistically significant associations for related measures (with gammas ranging from 0.36 to 0.73). Assessments using convergent measures also showed significant associations (with gammas ranging from 0.30 to 0.50).
    Conclusions: While no direct comparison can be made to a comparable questionnaire, our findings do suggest a number of strengths of the questionnaire but also the need to reduce item redundancy and to test its capacity to monitor changes over time.
    Language English
    Publishing date 2010-01-29
    Publishing country England
    Document type Journal Article
    ISSN 1478-4505
    ISSN (online) 1478-4505
    DOI 10.1186/1478-4505-8-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Tanzania national survey on iodine deficiency: impact after twelve years of salt iodation.

    Assey, Vincent D / Peterson, Stefan / Kimboka, Sabas / Ngemera, Daniel / Mgoba, Celestin / Ruhiye, Deusdedit M / Ndossi, Godwin D / Greiner, Ted / Tylleskär, Thorkild

    BMC public health

    2009  Volume 9, Page(s) 319

    Abstract: Background: In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal ... ...

    Abstract Background: In many low-income countries, children are at high risk of iodine deficiency disorders, including brain damage. In the early 1990s, Tanzania, a country that previously suffered from moderate to severe iodine deficiency, adopted universal salt iodation (USI) as an intervention strategy, but its impact remained unknown.
    Methods: We report on the first national survey in mainland Tanzania, conducted in 2004 to assess the extent to which iodated salt was used and its apparent impact on the total goitre prevalence (TGP) and urinary iodine concentrations (UIC) among the schoolchildren after USI was initiated. In 2004, a cross-sectional goitre survey was conducted; covering 140,758 schoolchildren aged 6 - 18 years were graded for goitre according to new WHO goitre classification system. Comparisons were made with district surveys conducted throughout most of the country during the 1980s and 90s. 131,941 salt samples from households were tested for iodine using rapid field test kits. UIC was determined spectrophotometrically using the ammonium persulfate digestion method in 4523 sub-sampled children.
    Results: 83.6% (95% CI: 83.4 - 83.8) of salt samples tested positive for iodine. Whereas the TGP was about 25% on average in the earlier surveys, it was 6.9% (95%CI: 6.8-7.0) in 2004. The TGP for the younger children, 6-9 years old, was 4.2% (95%CI: 4.0-4.4), n = 41,965. In the 27 goitre-endemic districts, TGP decreased from 61% (1980s) to 12.3% (2004). The median UIC was 204 (95% CF: 192-215) microg/L. Only 25% of children had UIC <100 microg/L and 35% were > or = 300 microg/L, indicating low and excess iodine intake, respectively.
    Conclusion: Our study demonstrates a marked improvement in iodine nutrition in Tanzania, twelve years after the initiation of salt iodation programme. The challenge in sustaining IDD elimination in Tanzania is now two-fold: to better reach the areas with low coverage of iodated salt, and to reduce iodine intake in areas where it is excessive. Particular attention is needed in improving quality control at production level and perhaps the national salt iodation regulations may need to be reviewed.
    MeSH term(s) Adolescent ; Child ; Cross-Sectional Studies ; Goiter/epidemiology ; Health Surveys ; Humans ; Iodine/administration & dosage ; Iodine/deficiency ; Iodine/urine ; Prevalence ; Sodium Chloride, Dietary/administration & dosage ; Tanzania/epidemiology
    Chemical Substances Sodium Chloride, Dietary ; iodized salt ; Iodine (9679TC07X4)
    Language English
    Publishing date 2009-09-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 1471-2458
    ISSN (online) 1471-2458
    DOI 10.1186/1471-2458-9-319
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Vitamin A supplementation in Tanzania

    Shekar Meera / Mshinda Hassan M / Schellenberg Joanna / Masanja Honorati / Mugyabuso Joseph KL / Ndossi Godwin D / de Savigny Don

    BMC Health Services Research, Vol 6, Iss 1, p

    the impact of a change in programmatic delivery strategy on coverage

    2006  Volume 142

    Abstract: Abstract Background Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on ... ...

    Abstract Abstract Background Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on Immunization (EPI+) approach to twice-yearly mass distribution campaigns on coverage of vitamin A supplementation in Tanzania Methods We investigated disparities in age, sex, socio-economic status, nutritional status and maternal education within vitamin A coverage in children between 1 and 2 years of age from two independent household level child health surveys conducted (1) during a continuous universal targeting scheme based on routine EPI contacts for children aged 9, 15 and 21 months (1999); and (2) three years later after the introduction of twice-yearly vitamin A supplementation campaigns for children aged 6 months to 5 years, a 6-monthly universal targeting scheme (2002). A representative cluster sample of approximately 2,400 rural households was obtained from Rufiji, Morogoro Rural, Kilombero and Ulanga districts. A modular questionnaire about the health of all children under the age of five was administered to consenting heads of households and caretakers of children. Information on the use of child health interventions including vitamin A was asked. Results Coverage of vitamin A supplementation among 1–2 year old children increased from 13% [95% CI 10–18%] in 1999 to 76% [95%CI 72–81%] in 2002. In 2002 knowledge of two or more child health danger signs was negatively associated with vitamin A supplementation coverage (80% versus 70%) (p = 0.04). Nevertheless, we did not find any disparities in coverage of vitamin A by district, gender, socio-economic status and DPT vaccinations. Conclusion Change in programmatic delivery of vitamin A supplementation was associated with a major improvement in coverage in Tanzania that was been sustained by repeated campaigns for at least three years. There is a need to monitor the effect of such campaigns on the routine health system and on equity of coverage. Documentation of vitamin A supplementation campaign contacts on routine maternal and child health cards would be a simple step to facilitate this monitoring.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2006-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article: Efficacy trials of a micronutrient dietary supplement in schoolchildren and pregnant women in Tanzania.

    Latham, Michael C / Ash, Deborah M / Makola, Diklar / Tatala, Simon R / Ndossi, Godwin D / Mehansho, Haile

    Food and nutrition bulletin

    2003  Volume 24, Issue 4 Suppl, Page(s) S120–8

    Abstract: Traditionally, the main strategies used to control micronutrient deficiencies have been food diversification, consumption of medicinal supplements, and food fortification. In Tanzania, we conducted efficacy trials using a dietary supplement as a fourth ... ...

    Abstract Traditionally, the main strategies used to control micronutrient deficiencies have been food diversification, consumption of medicinal supplements, and food fortification. In Tanzania, we conducted efficacy trials using a dietary supplement as a fourth approach. These were randomized, double-blind, placebo-controlled efficacy trials conducted separately first in children and later in pregnant women. The dietary supplement was a powder used to prepare an orange-flavored beverage. In the school trial, children consumed 25 g per school day attended. In the pregnancy trial, women consumed the contents of two 25-g sachets per day with meals. This dietary supplement, unlike most medicinal supplements, provided 11 micronutrients, including iron and vitamin A, in physiologic amounts. In both trials we compared changes in subjects consuming either the fortified or the nonfortified supplement. Measures of iron and vitamin A status were similar in the groups at the baseline examination, but significantly different at follow-up, always in favor of the fortified groups. Children receiving the fortified supplement had significantly improved anthropometric measures when compared with controls. At four weeks postpartum, the breast milk of a supplemented group of women had significantly higher mean retinol content than did the milk of mothers consuming the nonfortified supplement. The advantages of using a fortified dietary supplement, compared with other approaches, include its ability to control several micronutrient deficiencies simultaneously; the use of physiologic amounts of nutrients, rather than megadoses that require medical supervision; and the likelihood of better compliance than with the use of pills because subjects liked the beverage used in these trials.
    MeSH term(s) Beverages ; Child ; Dietary Supplements ; Female ; Food, Fortified ; Humans ; Male ; Micronutrients/adverse effects ; Micronutrients/deficiency ; Micronutrients/therapeutic use ; Patient Compliance ; Pregnancy ; Randomized Controlled Trials as Topic ; Tanzania ; Treatment Outcome
    Chemical Substances Micronutrients
    Language English
    Publishing date 2003-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 449173-7
    ISSN 0379-5721
    ISSN 0379-5721
    DOI 10.1177/15648265030244S209
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Randomized efficacy trial of a micronutrient-fortified beverage in primary school children in Tanzania.

    Ash, Deborah M / Tatala, Simon R / Frongillo, Edward A / Ndossi, Godwin D / Latham, Michael C

    The American journal of clinical nutrition

    2003  Volume 77, Issue 4, Page(s) 891–898

    Abstract: Background: Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies.: Objective: We determined whether a beverage fortified with 10 ... ...

    Abstract Background: Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies.
    Objective: We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children (aged 6-11 y) attending primary schools.
    Design: In this randomized, double-blind, placebo-controlled efficacy trial, children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo.
    Results: There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status, serum retinol, and anthropometry. At the 6-mo follow-up, among children with anemia (hemoglobin < 110 g/L), there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group (9.2 and 0.2 g/L, respectively). Of those who were anemic at baseline, 69.4% in the nonfortified group and 55.1% in the fortified group remained anemic at follow-up (RR: 0.79), a cure rate of 21%. The prevalence of children with low serum retinol concentrations (< 200 microg/L) dropped significantly from 21.4% to 11.3% in the fortified group compared with a nonsignificant change (20.6% to 19.7%) in the nonfortified group. At follow-up, mean incremental changes in weight (1.79 compared with 1.24 kg), height (3.2 compared with 2.6 cm), and BMI (0.88 compared with 0.53) were significantly higher in the fortified group than in the nonfortified group.
    Conclusion: The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency.
    MeSH term(s) Anemia, Iron-Deficiency/drug therapy ; Anemia, Iron-Deficiency/epidemiology ; Anemia, Iron-Deficiency/prevention & control ; Beverages ; Body Height ; Body Mass Index ; Body Weight ; Child ; Double-Blind Method ; Female ; Ferritins/blood ; Food, Fortified ; Hemoglobins/analysis ; Humans ; Male ; Micronutrients/administration & dosage ; Parasitic Diseases/complications ; Parasitic Diseases/drug therapy ; Placebos ; Schools ; Tanzania/epidemiology ; Vitamin A/blood ; Vitamin A Deficiency/drug therapy ; Vitamin A Deficiency/epidemiology ; Vitamin A Deficiency/prevention & control
    Chemical Substances Hemoglobins ; Micronutrients ; Placebos ; Vitamin A (11103-57-4) ; Ferritins (9007-73-2)
    Language English
    Publishing date 2003-04
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 280048-2
    ISSN 1938-3207 ; 0002-9165
    ISSN (online) 1938-3207
    ISSN 0002-9165
    Database MEDical Literature Analysis and Retrieval System OnLINE

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