Maternal micronutrient status as a risk factor for perinatal mortality in a Tanzanian randomized controlled trial

The objective of this study was to determine if maternal micronutrient status (specifically iron) during pregnancy is a risk factor for perinatal mortality among women in Tanzania. Secondary analysis of data from a randomized, double-blind, placebo-controlled vitamin A supplementation trial conducted between August 2010-March 2013 was used to assess iron intake among women who experienced a stillbirth or early neonatal death. The mean dietary iron intake (measured using a quantitative Food Frequency Questionnaire) for this population was 12.64 mg/day (SD = 6.32). There were 206 cases of perinatal mortality. Three classifications of dietary iron intake were devised and risk ratios were calculated using the Log Binomial Regression Model: <18 mg/day (RR: 2.13), 18-27 mg/day (RR: 2.63), & >27 mg/day (the reference group to which the first two classification groups were compared).There was neither a significant relationship found among women who consumed iron levels <18 mg/day or between 18-27 mg/day of iron compared to women who consumed more than 27 mg/day of iron, but on average there was twice the risk for perinatalmortality. The current study is consistent with previous literature findings and supports the need for more efficacious nutrition strategies. (Afr J Reprod Health 2022; 26[7]: 38-48).

Health and educational achievement of school-aged children: The impact of anaemia and iron status on learning

Background: Anaemia is a common blood disorder in children and is known to cause complications such as lethargy and stress on bodily organs. Children from disadvantaged communities often fail to achieve their age-related potential with iron deficiency anaemia stated as a risk factor through causing inattentiveness and learning problems. Limited evidence exists for the adverse effects of iron deficiency anaemia on the developing child's brain from South African studies. Aim: The objective of this study was to determine the local prevalence of anaemia and iron deficiency and to examine their association with psychomotor development and school performance in school-aged children. Setting: This study was conducted in a peri-urban disadvantaged community from KwaZulu-Natal, South Africa. Methods: Children aged 6 to 8 years from KwaZulu-Natal were enrolled (n = 184). Three parameters of assessment were used: clinical data, biochemical data (haemoglobin levels and iron studies) and school performance (interviews with caregivers, teachers and the children). Anaemia presence and iron deficiency were the hypothesised mediating variables through which growth, development and school performance were influenced. Results: A high point prevalence of anaemia (23.4%), iron deficiency anaemia (4.9%) and helminth infection (27.1%) was identified. Impaired cognitive assessment scores (20.7%) were prevalent in the children sampled. Behavioural problems (4.3%), poor memory function (4.3%) and impaired attention (1.1%) were of low prevalence. Anaemia and iron deficiency were both associated with impaired fine motor skills (p < 0.05). Anaemia was significantly associated with low cognitive scores (p = 0.01). Neither anaemia, iron status nor helminth infection significantly predicted school performance in the children sampled. Conclusions: The point prevalence of anaemia and iron deficiency among the sampled children was higher than the national prevalence. The sample size was however inadequate for drawing statistical conclusions about psychomotor development and school performance because of the low prevalence of the different outcomes that were examined. Practical challenges faced in conducting this investigation in rural South African schools were discussed

Connaissances et pratiques de la prescription du fer par le personnel du service de pediatrie du chu Gabriel Toure de Bamako

But : Evaluer les connaissances et les pratiques relatives a la prescription du fer dans le service de pediatrie du Centre Hospitalier Universitaire Gabriel Toure (CHU-GT) de Bamako; Mali. Materie( et methodes: Il s'agissait d'une etude transversale realisee du 1 er au 30 Juillet 2012 a la pediatrie. Nous avons soumis un questionnaire aux prestataires et analyse les dossiers des enfants ages de 1 a 60 mois hospitalises ayant recu du fer. Le consentement des prescripteurs a ete demande et obtenu au prealable. Resu(tats: nous avons enquete cinquante prestataires dont 10 pediatres (20%); 31 medecins CES de pediatrie (62 %); 2 medecins generalistes (4%); 7 etudiants en fin de cycle medical (14%) et analyse 100 dossiers. Trente pour cent des prestataires ont correctement defini le fer. Plus de la moitie des prestataires connaissaient les besoins en fer chez l'enfant. Les reserves en fer etaient connues de 42% des prestataires. Huit pour cent des prestataires savaient que les fers apportes par l'alimentation etaient le fer heminique ou le fer non heminique. Trente pourcent des malades ont recu le fer a la dose de 8 a 10mg/kg. La duree du traitement n'a pas ete precisee chez 92% des malades. Conc(us ion : Dans notre contexte la bonne connaissance theorique des indications et des regles de prescription du fer chez l'enfant n'excluait pas les mauvaises pratiques de sa prescription. D'autres travaux devraient analyser les raisons de cette discordance

Assessment of Musculoskeletal Disorders and Absenteeism at a Foundry

Background: Musculoskeletal disorders are a major health problem globally and a significant cause of disability in the workplace. The purpose of this study was to describe tasks and body movements associated with the high rate of musculoskeletal-related complaints and absenteeism at a foundry in South Africa.Methods: A quantitative study design was used. The data sources were a questionnaire administered to 38 participants; structured observation and company records. Descriptive statistics were used to analyse the data. Results: All the participants were exposed to poor ergonomics which resulted in repetitive movements; twisting; gripping; and standing or sitting for long periods of time. Pain in the back and shoulders was the most common complaint; followed by stiffness of the fingers; wrists and shoulders. Most participants reported absence from work due to musculoskeletal complaints

Iron status and cardiovascular disease risk in black South African women: the PURE study

Objective: To examine the associations between measures of iron status and cardiovascular disease (CVD) risk factors in South African women.Method: In a cross-sectional study; demographic information and health history were obtained during individual interviews using validated questionnaires in the North West Province; South Africa. Anthropometric indices; iron indices; blood pressure; blood glucose and lipid profiles were measured using standard procedures in 1 262 apparently healthy black South African women aged 35 years or older. Iron status was assessed using serum concentrations of ferritin; transferrin receptor (TfR) and TfR:ferritin ratio.Results: Associations between iron status parameters and CVD risk factors were generally weak (r 0.3; p 0.01) and were not retained when adjustment was made for age; body mass index; smoking; alcohol consumption and C-reactive protein in the analysis. Waist circumference (WC) and waist:hip ratio (WHR) were higher in the fourth quartile of serum ferritin than in the third quartile; and also in the third quartile compared to the second quartile (P 0.05). Based on WC and WHR respectively; 31 and 52of the women had excess abdominal obesity. The mean (95 confidence interval) serum TfR concentration was high; at 9.09 ?g/ml (8.77; 9.44); indicating risk of iron deficiency. The mean (95 confidence interval) concentrations of lipids [total cholesterol 4.78 mmol/l (4.64; 4.93); high-density lipoprotein cholesterol 1.45 mmol/l (1.39; 1.52); low-density lipoprotein cholesterol 1.65 mmol/l (1.53; 1.78); triglyceride 1.12 mmol/l (1.07; 1.18)] were within reference ranges.Conclusion: No significant association was found between iron status parameters and established CVD risk factors. However; excessive abdominal adiposity indicated by high WC and WHR contributes significantly to increased serum ferritin concentration in this population

Assessment of Iron Content of Breast Milk in Preterm and Term Mothers in Enugu Urban

Background: It is commonly assumed that preterm babies are malnourished and this has led to all forms of micronutrient supplementation including iron. Objective:The aim of the study is to compare the iron content in breast milk of mothers who had preterm and term babies.Methods:Ninety six (96) lactating mothers who delivered their babies at term and 68 lactating mothers who had preterm deliveries were recruited for the study. The mothers were attending the postnatal clinic of one secondary and two tertiary healthcare facilities in Enugu. Breast milk iron concentration was determined by Atomic Absorption Spectrophotometer.Results:The differences in the mean values for the iron concentrations in preterm and term breast milk were statistically significant (39.06±10.78 versus 32.79±14.17 µmol/L, P =0.02). In both groups, the breast milk iron concentration gradually decreased as lactation progressed. (P <0.0001).Conclusion:The iron content of breast milk from mothers who had preterm babies is higher when compared to mothers who had term babies. It may thus be needless to introduce exogenous iron during lactation

Intoxicatrion accidentelle par ingestion de fer chez l'enfant : a propos de deux cas a Dakar

Introduction : L'intoxication au fer est un motif exceptionnel d'hospitalisation en pediatrie au centre hospitalier universitaire de Dakar.Observations : Nous rapportons les observations de deux enfants de 3 ans et 20 mois admis au service d'urgence pediatrique de l'hopital Aristide Le Dantec pour une intoxication de moderee a severe apres l'absorption d'une quantite importante de sulfate de fer. Les manifestations cliniques etaient dominees par les troubles digestifs et les troubles neurologiques a type de convulsions tonico-cloniques et de coma stade I. Le dosage sanguin du fer montrait des taux au dessus des limites normales. L'evolution clinique etait satisfaisante apres le lavage gastrique et les mesures de reanimation. Conclusion : Un diagnostic precoce et une prise en charge diligente des cas d'intoxication au fer permet d'en reduire la morbidite et la mortalite. Nous insistons egalement sur l'information des familles pour une meilleure securisation des comprimes de fer prescrits aux adultes

Conclusions et recommandations a l'issue de la consultation de l'OMS sur la lutte contre la carence martiale chez le nourrisson et le jeune enfant dans les pays d'endemie palustre

Cet article presentent les resultats d'une Consultation d'Experts dont l'objectif etait d'evaluer l'efficacite et l'innocuite des supplements de fer administres aux nourrissons et aux jeunes enfants dans les zones d'endemie palustre; ainsi que les consequences d'une telle mesure pour la sante publique. Les participants a cette Consultation; qui s'est deroulee a Lyon (France) les 12-14 juin 2006; se sont entendus sur plusieurs questions importantes concernant l'administration d'une supplementation martiale aux nourrissons et aux jeunes enfants dans les zones d'endemie palustre. Les conclusions du present rapport s'appliquent plus particulierement aux pays ou le paludisme est endemique

Effect of Traditional Beer Consumption on the Iron Status of A Rural South African Population

Objective.To determine the effect of traditional beer consumption on the iron status of rural black subjects.Design. A cross-sectional study was undertaken.Setting. Dikgale field site and the surrounding villages in Limpopo Province; South Africa.Subjects. Eight hundred and forty-four non-alcohol consumers (738 women and 106 men) and 280 alcohol consumers (163 women and 117 men) aged 30 years and above; participated in the study.Outcome measures. Outcome measures included alcohol consumption; serum ferritin levels; percentagetransferrin saturation; total iron-binding capacity; haemoglobin and C-reactive protein levels.Results. Traditional beer fermented in either iron pots or plastic containers was found to have iron levels ranging from 15 mg/l to 67.8 mg/l and 6 mg/l to 17 mg/l; respectively. Iron status as measured by serum ferritin; serum iron; percentage transferrin saturation; and haemoglobin levels was significantly higher in alcohol consumers than in non-consumers; even after adjustment for age and C-reactive protein (CRP) levels. A high percentage of women (12.3) and men (8.2) consuming alcohol had iron overload.Conclusion. This study showed that consumption of traditional beer in a non-urban population in Limpopo Province was associated with high levels of markers of iron status. Traditional beer consumption seemed to prevent iron deficiency in those at risk of developing such deficiency; but appeared to precipitate iron overload in those at risk of developing iron overload

Incidence de l'anemie en saison de forte transmission du paludisme a Doneguebougou a propos de volontaires de 6 mois a 6 ans traites par du fer puis soumis a une chimioprophylaxie antipaludique

Les populations a risque d'anemie en zone subsaharienne sont les nourrissons; les jeunes enfants et les femmes enceintes. Les deux principales etiologies reconnues a ces anemies sont la carence martiale et le paludisme. L'importance relative de chacune de ces etiologies est cependant difficile a mesurer; car elles sont souvent en association ou; intriquees a d'autres etiologies notamment infectieuses. Notre etude se proposait d'explorer l'hypothese d'un impact favorable d'une supplementation martiale a dose curative chez des sujets anemies de 6 mois a 6 ans; sur l'incidence de l'anemie et de l'anemie grave associees au paludisme a Plasmodium falciparum dans cette population en periode de forte transmission du paludisme. Nous avons evalue et suivi les parametres hemoglobine; prevalence et incidence de l'anemie; IP et acces de paludisme dans une population d'enfants ages de 6 mois a 6 ans durant 5 mois de transmission du paludisme dans un village rural du Mali. Les sujets inclus dans l'etude ont recu un traitement martial de 45 jours par du Fumarate ferreux quand ils etaient anemies. Tous ont recu un traitement curatif antipaludique par la chloroquine avant d'etre randomises entre deux groupes de suivi dont l'un etait assigne a une chimioprophylaxie antipaludique a base de chloroquine et de proguanil et l'autre a un suivi sans chimioprophylaxie antipaludique. Parmi 227 sujets inclus; 217 ont ete suivis durant les 5 mois de suivi. Le traitement martial de 45 jours a ete institue chez 160 sujets pour anemie dont 157 ont ete revus au bout du traite- ment et en fin de suivi de cohorte. Le nombre de sujets ayant corrige leur anemie a la fin du traitement martial etait de 87 soit 55;4. Au cours du suivi; 5 cas d'anemie severe ont ete diagnostiques ; aucun de ces cas n'etait releve dans le groupe d'enfants initialement traites par du fer. Nous n'avons pas trouve de risque plus grand de faire un palu- disme lorsque les sujets avaient recu prealablement du fer pour anemie; mais nous notions plus significativement d'acces de paludisme chez les sujets gueris de leur anemie que chez ceux qui n'avaient pas corrige leur anemie au bout des 45 jours de traitement martial. Nous concluons que la carence martiale est une cause importante d'anemie dans la population de nourrissons et d'enfants de 6 mois a 6 ans et que le traitement martial presomptif de l'anemie en debut de forte transmission du paludisme; a un effet benefique; pour cette population pendant la saison de forte transmission du paludisme en zone subsaharienne

A Study of Surface Proteins; Other Adhesins and Iron Acquiring Mechanisms in the Pathogenesis of Neisseria gonorrhoea strains Isolated from STD Patients in Ethiopia

The prevalence of Neisseria gonorrhoeae surface antigens as virulence factors in patients with sexually transmitted disease (STD) was determined. In addition; the potential of viral surface components as vaccine candidates against gonococcal infections was assessed. 335 urogenital specimens from male and female STD patients in Addis Ababa; Nazareth and Awassa; Ethiopia; were examined for N. gonorrhoeae. The virulence type; antimicrobial sensitivity pattern and surface antigenic components of isolated N. gonorrhoeae strains were determined using haemagglutination and other detection assay methods. Out of 335 specimens; N. gonorrhoeae strains were isolated in 59 of males and 43 of females. These strains showed 19 different antibiogram patterns. Only 12.3 of strains were sensitive to all drugs and over 70 were resistant to more than 2 combined drugs. More than 90 of these multidrug resistant strains were penicillinase [beta-lactamase] producers. 200 N. gonorrhoeaeisolates were tested for haemagglutination and iron-binding protein production (IBP). Results showed that 35 of tested isolates were mannose resistant haemagglutinating (MRHA) strains and 20 were mannose sensitive haemagglutinating (MSHA) strains when tested using the human AB blood type. When guinea pig blood cells were used; 15 were MRHA and 25 were MSHA strains. MRHA strains were positive for IBP; whereas only 10 of MSHA strains were positive for this property. Conclusions and recommendations are given