Search

Objective: To perform a systematic review to evaluate iron, vitamin A, zinc, and iodine status and intakes in children and adolescents (0-19 years) in Ethiopia, Kenya, Nigeria, and South Africa.Method: Both national and subnational data published from the year 2005 to 2015 were searched via MEDLINE, Scopus, and national public health websites. For each micronutrient and country, status data from relevant studies and surveys were combined into an average prevalence and weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes.Results: This review included 55 surveys and studies, 17 from Ethiopia, 11 from Kenya, 12 from Nigeria, and 16 from South Africa. The WAVG prevalence of anemia ranged from 25% to 53%, iron deficiency from 12% to 29%, vitamin A deficiency (VAD) from 14% to 42%, zinc deficiency from 32% to 63%, and iodine deficiency from 15% to 86% in children aged 0 to 19 years from 4 countries. Generally, children <5 years had higher prevalence of anemia (32%-63%), VAD (15%-35%), and zinc deficiency (35%-63%) compared to children aged 5 to 19 years. Studies with intake data indicated that inadequate intakes ranged from 51% to 99% for zinc, 13% to 100% for iron, and 1% to 100% for vitamin A. Households failing to consume adequately iodized (>15 ppm) salt ranged from 2% in Kenya to 96% in Ethiopia.Conclusion: With large variation within the 4 African countries, our data indicate that anemia and vitamin A, zinc, and iodine deficiencies are problems of public health significance. Effective public health strategies such as dietary diversification and food fortification are needed to improve micronutrient intake in both younger and older children. [ABSTRACT FROM AUTHOR]

Background: Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies. Objective: To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions. Design: From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992-2012, but two-thirds of the observations related to 2006-2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality. Results: Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level. Conclusions: The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology. [ABSTRACT FROM AUTHOR]