Clinic-based Assessment of Folate Levels for Women of Reproductive Age, as an Impact Indicator for a National Food Fortification Program in Tanzania
Ramadhani Abdallah Noor *
Africa Academy for Public Health (AAPH), Dar Es Salaam, Tanzania and Harvard School of Public (HSPH)Health, Boston, Massachusetts, USA.
Salum Mshamu
Africa Academy for Public Health (AAPH), Dar Es Salaam, Tanzania.
Nzovu Ulenga
Africa Academy for Public Health (AAPH), Dar Es Salaam, Tanzania and Harvard School of Public (HSPH)Health, Boston, Massachusetts, USA.
Ellen Hertzmark
Harvard School of Public (HSPH)Health, Boston, Massachusetts, USA.
Wafaie Fawzi
Harvard School of Public (HSPH)Health, Boston, Massachusetts, USA.
Margaret Benjamin
Hellen Keller International, Tanzania, Dar Es Salaam, Tanzania.
George Kaishozi
Hellen Keller International, Tanzania, Dar Es Salaam, Tanzania.
Simon Tatala
Hellen Keller International, Tanzania, Dar Es Salaam, Tanzania.
Christina Nyhus Dhillon
Hellen Keller International, Tanzania, Dar Es Salaam, Tanzania.
Ramadhani Mwiru
Africa Academy for Public Health (AAPH), Dar Es Salaam, Tanzania.
Nilupa Gunaratna
Harvard School of Public (HSPH)Health, Boston, Massachusetts, USA.
*Author to whom correspondence should be addressed.
Abstract
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.