Clinic-based Assessment of Folate Levels for Women of Reproductive Age, as an Impact Indicator for a National Food Fortification Program in Tanzania.

Objectives: To determine prevalence of folate deficiency and effectiveness of the National Food Fortification Program on folate levels among women of reproductive age in Tanzania. Methods: A Prospective cohort study comparing participants’ folate levels prior and gradually upon the roll-out and scale-up of the national food fortification program. A total of 636 women of reproductive age (18-49 years) enrolled and undergoing follow-up across 10 primary health facilities in Dar Es Salaam. Blood samples, food frequency, and fortified food consumption data collected at baseline (prior the program roll out), 6, 9 and 12 months. Serum folate assays performed using e411Cobas machine and results merged with food frequency and intake data. Results: We present baseline and follow-up data, estimating pre & fortification era folate levels for women of reproductive age in Tanzania. More than 25% of women have pre-fortification intake <80% their RDA for folate (mean 446, median 416, IQR ranging between 313-551micrograms). Wheat consumption is high with median portion intake of wheat-carbohydrates approximating 1 portion/day. demographics, complementing serum folate assays results will be presented. Conclusions: Low folate intake and high wheat consumption suggest potential for mandatory folate fortification of wheat in Tanzania.

Feasibility and Effectiveness of Introducing a Six-month Contact Point for Vitamin A Supplementation into the Tanzanian EPI Vaccination Calendar.

Objectives: The study was seeking to; 1. Obtain the age at first vitamin A dose in comparison to current practices. 2. Assess acceptability of a new 6 month contact point by caretakers and health care workers. Methods: A randomized, facility-based intervention trial was implemented in four intervention and two control health facilities. Children (435 intervention, 137 control) were enrolled at 12-14 weeks of age during their DPT3 visit and followed until they were nine months. At intervention facilities, VAS, growth monitoring and IYCF counseling were provided at six months while standard care of growth monitoring was offered at control facilities. Results: The median (IQR) age at first receipt of VAS was 6.3 (6.0, 6.8) months in the intervention group and 9.3 (9.1, 9.6) months in the control group (p<0.001). At six-months of age, clinic attendance was 88% in the intervention group compared with 0% in the control group. Health workers reported no negative effect on their routine work and 93% recommended the six-month contact point to be implemented in other facilities. Conclusions: Introduction of a six-month contact point into the EPI vaccination calendar significantly reduced the age of first receipt of VAS for children and was well-accepted by health workers.