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Background/Objectives:: Fortifying cereal staples with zinc is a strategy for increasing zinc intake in young children in developing countries. However, phytic acid (PA) naturally present in cereals strongly decreases zinc absorption. A stable-isotope zinc absorption study was conducted in young children to investigate the ability of the PA-degrading enzyme phytase to improve zinc absorption, when added to a cereal porridge immediately before consumption. Subjects/Methods:: Fractional absorption of zinc (FAZ) was estimated in 35 young healthy Burkinabe children using the double-isotopic tracer ratio method with 67Zn as oral tracer and 70Zn as intravenous tracer, in a crossover design. The test meals were: (a) a millet-based porridge containing 1.4 mg total zinc (native plus 1 mg added as ZnSO4) with a PA:Zn molar ratio of 7.7; (b) the same porridge with the enzyme phytase (20.5 phytase units (FTU)) added immediately before consumption. The exchangeable zinc pool (EZP) was determined as a potential measure of long-term zinc intake in 20 of the 35 children and compared with FAZ. Results:: Mean FAZ increased from 9.5±3.4 to 16.0±5.1% (P<0.0001), when phytase was added to the meal. The mean EZP was 3.6±0.5 mg/kg. There was no correlation between the EZP and FAZ values for either of the two test meals. Conclusions:: Adding phytase immediately prior to consumption of a zinc-fortified cereal-based complementary food can improve zinc absorption in young children.

Total hip replacement (THR) still is a rare intervention in many African countries. In Burkina Faso it is not performed on a regular basis. A visiting programme for THR was started in a district hospital with no previous relevant experience. In this paper we present an analysis of the surgical technical problems and peri-operative complications of 152 THRs in 136 patients and three bipolar hemiarthroplasties in three patients undertaken in this new programme with limited orthopaedic equipment. There were 86 male and 53 female patients with a mean age of 49 years (21 to 78). We identified 77 intra-operative technical problems in 51 operations. There were 24 peri-operative complications in 21 patients, 17 of which were bony in nature. So far, ten revision THRs have been performed in nine patients.Regular analysis of the technical problems and complications was used to improve quality, and we identified patient selection adapted to the local circumstances as important to avoid complications. Our reflections on the problems encountered in initiating such a programme may be of help to other teams planning similar projects.Cite this article: Bone Joint J2014;96-B:177–80.