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Background: Maize-meal porridge is used for infant feeding in many African countries, including South Africa. A low-cost, finely milled, maize-meal porridge was fortified with [beta]-carotene, iron, and zinc (100% of recommended dietary allowance), as well as ascorbic acid, copper, selenium, riboflavin, vitamin B-6, vitamin B-12, and vitamin E. Objective: We assessed whether the fortified porridge could reduce anemia and improve the micronutrient status and motor development of infants. Design: Infants aged 6-12 mo (n = 361) were randomly assigned to receive either the fortified or unfortified porridge for 6 mo. Primary outcomes were hemoglobin and serum retinol, zinc, and ferritin concentrations and motor development. Growth was assessed as a secondary outcome. Primary and secondary outcomes were assessed at baseline and 6 mo. Results: Two hundred ninety-two infants completed the study. The fortified-porridge group had an intervention effect of 9.4 [micro]g/L (95 % CI: 3.6, 15.1 [micro]g/L) for serum ferritin and 9 g/L (95% CI: 6, 12 g/L) for hemoglobin concentrations. The proportion of infants with anemia decreased from 45% to 17% in the fortified-porridge group, whereas it remained >40% in the control group. The fortified-porridge group achieved on average 15.5 of the 25 motor development score items, whereas the control group achieved 14.4 items (P = 0.007). Serum retinol concentration showed an inconsistent effect, and no intervention effect was observed for serum zinc concentrations. Conclusions: This low-cost fortified porridge can potentially have a significant effect in reducing anemia and improving iron status and motor development of infants in poor settings. The formulation needs some adjustment in terms of zinc fortification. KEY WORDS Fortified porridge, infants, micronutrients, anemia, motor development

Abstract Objective To measure the effects of iron supplementation and anthelmintic treatment on iron status, anaemia, growth, morbidity, and development of children aged 6-59 months. Design Double blind, placebo controlled [...]

ABSTRACTThe dearth of locally developed measures of language makes it difficult to detect language and communication problems among school-age children in sub-Saharan African settings. We sought to describe variability in vocabulary acquisition as an important element of global cognitive functioning. Our primary aims were to establish the psychometric properties of an expressive vocabulary measure, examine sources of variability, and investigate the measure’s associations with non-verbal reasoning and educational achievement. The study included 308 boys and girls living in a predominantly rural district in Kenya. The developed measure, the Kilifi Naming Test (KNT), had excellent reliability and acceptable convergent validity. However, concurrent validity was not adequately demonstrated. In the final regression model, significant effects of schooling and area of residence were recorded. Contextual factors should be taken into account in the interpretation of test scores. There is need for future studies to explore the concurrent validity of the KNT further.

Background: Deficiencies of iron, iodine, and vitamin A are prevalent worldwide and can affect the mental development and learning ability of schoolchildren. Objective: The aim of this study was to determine the effect of micronutrient-fortified biscuits on the micronutrient status of primary school children. Design: Micronutrient status was assessed in 115 children aged 6-11 y before and after consumption of biscuits (fortified with iron, iodine, and [Beta]-carotene) for 43 wk over a 12-mo period and was compared with that in a control group (n = 113) who consumed nonfortified biscuits. Cognitive function, growth, and morbidity were assessed as secondary outcomes. Results: There was a significant between-group treatment effect on serum retinol, serum ferritin, serum iron, transferrin saturation, and urinary iodine (P [is less than] 0.0001) and in hemoglobin and hematocrit (P [is less than] 0.05). The prevalence of low serum retinol concentrations ([is less than] 0.70 [micro] mol/L) decreased from 39.1% to 12.2%, of low serum ferritin concentrations ([is less than] 20 [micro]g/L) from 27.8% to 13.9%, of anemia (hemoglobin [is less than] 120 g/L) from 29.6% to 15.6%, and of low urinary iodine concentrations ([is less than] 100 [micro] g/L) from 97.5% to 5.4%. There was a significant between-group treatment effect (P [is less than] 0.05) in cognitive function with the digit span forward task (short-term memory). Fewer school days were missed in the intervention than in the control group because of respiratory (P = 0.097) and diarrhea-related (P = 0.013) illnesses. The intervention had no effect on morbidity and cognitive function. Conclusions: Fortified biscuits resulted in a significant improvement in the micronutrient status of primary school children from a poor rural community and also appeared to have a favorable effect on anthropometric status. Am J Clin Nutr 1999;69:497-503. KEY WORDS Vitamin A, [Beta]-carotene, iron, iodine, fortification, school feeding program, micronutrient deficiencies, intervention, cognitive function, morbidity, primary school children

In rural areas, a lack of infrastructure often limits the promotion and implementation of community-based nutrition activities. Growth monitoring can potentially provide a platform for the promotion and implementation of community-based nutrition activities, provided that the growth-monitoring program has a high coverage. The aim of this study was to determine the acceptability of a community-based growth-monitoring project in terms of child attendance and maternal attitude. The study was done in a mountainous rural village that lacks health facilities in KwaZulu-Natal, South Africa. Attendance registers from 1996 to 2000 were used to determine the attendance ratio, coverage, adequacy of growth monitoring, and frequency distribution of the age of participating children. In 2001, focus group discussions were used for the qualitative assessment of maternal attitudes. The community-based growth-monitoring project had an estimated coverage of 90%, at least 60% of these children were covered adequately, and attendance was equally distributed over one-year-interval age categories for children aged five years and younger. Community-based growth monitoring can therefore provide a suitable platform for the promotion and implementation of community-based nutrition activities.