Elizabeth A Lundeen1,2, Jennifer N Lind3, Kristie E N Clarke3, Nancy J Aburto3,4, Cholpon Imanalieva5, Tursun Mamyrbaeva6, Asel Ismailova6, Arnold Timmer7,8, Ralph D Whitehead9, Larissa Praslova10, Galina Samohleb10, Muktar Minbaev5, O Yaw Addo9, Mary K Serdula9. 1. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. yxj4@cdc.gov. 2. Epidemic Intelligence Service assigned to the Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA. yxj4@cdc.gov. 3. Epidemic Intelligence Service assigned to the Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. World Food Program, Rome, Italy. 5. United Nations Children's Fund (UNICEF)-Kyrgyz Republic country office, Bishkek, Kyrgyz Republic. 6. Kyrgyz Republic Ministry of Health, Bishkek, Kyrgyz Republic. 7. UNICEF, New York City, NY, USA. 8. Global Alliance for Improved Nutrition, Geneva, Switzerland. 9. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. 10. Kyrgyz Republic Department of Statistics, Bishkek, Kyrgyz Republic.
Abstract
BACKGROUND/ OBJECTIVES: In 2009, the Ministry of Health of Kyrgyzstan launched a national Infant and Young Child Nutrition (IYCN) program which included point-of-use fortification of foods with micronutrient powders (MNP) containing iron, vitamin A, and other micronutrients. Caretakers of children aged 6-23 months were given 30 sachets of MNP every 2 months. Micronutrient surveys were conducted in 2009 and 2013. The objective of the study was to compare the prevalence of anemia and deficiencies of iron and vitamin A among children aged 6-29 months prior to the MNP program (2009) with those after full implementation (2013). SUBJECTS/ METHODS: Cross-sectional national surveys were conducted in 2009 (n = 666) and 2013 (n = 2150). Capillary blood samples were collected to measure hemoglobin, iron (ferritin and soluble transferrin receptor [sTfR]) and vitamin A (retinol binding protein [RBP]) status, and inflammation status (C-reactive protein [CRP] and α-1-acid glycoprotein [AGP]). Ferritin, sTfR, and RBP were adjusted for inflammation; hemoglobin was adjusted for altitude. RESULTS: The prevalence of anemia was non-significantly lower in 2013 compared to 2009 (32.7% vs. 39.0%, p = 0.076). Prevalence of inflammation-adjusted iron deficiency (54.8% vs. 74.2%, p<0.001) and iron deficiency anemia (IDA, 25.5% vs. 35.1%, p = 0.003) were lower and the prevalence of inflammation-adjusted vitamin A deficiency was higher (4.3% vs. 2.0%, p = 0.013) in 2013 compared to 2009. CONCLUSIONS: Four years after the initiation of a national Infant and Young Child Nutrition program including the introduction of point-of-use fortification with MNP, the prevalence of iron deficiency and IDA is lower, but the prevalence of vitamin A deficiency is higher.
BACKGROUND/ OBJECTIVES: In 2009, the Ministry of Health of Kyrgyzstan launched a national Infant and Young Child Nutrition (IYCN) program which included point-of-use fortification of foods with micronutrient powders (MNP) containing iron, vitamin A, and other micronutrients. Caretakers of children aged 6-23 months were given 30 sachets of MNP every 2 months. Micronutrient surveys were conducted in 2009 and 2013. The objective of the study was to compare the prevalence of anemia and deficiencies of iron and vitamin A among children aged 6-29 months prior to the MNP program (2009) with those after full implementation (2013). SUBJECTS/ METHODS: Cross-sectional national surveys were conducted in 2009 (n = 666) and 2013 (n = 2150). Capillary blood samples were collected to measure hemoglobin, iron (ferritin and soluble transferrin receptor [sTfR]) and vitamin A (retinol binding protein [RBP]) status, and inflammation status (C-reactive protein [CRP] and α-1-acid glycoprotein [AGP]). Ferritin, sTfR, and RBP were adjusted for inflammation; hemoglobin was adjusted for altitude. RESULTS: The prevalence of anemia was non-significantly lower in 2013 compared to 2009 (32.7% vs. 39.0%, p = 0.076). Prevalence of inflammation-adjusted iron deficiency (54.8% vs. 74.2%, p<0.001) and iron deficiency anemia (IDA, 25.5% vs. 35.1%, p = 0.003) were lower and the prevalence of inflammation-adjusted vitamin A deficiency was higher (4.3% vs. 2.0%, p = 0.013) in 2013 compared to 2009. CONCLUSIONS: Four years after the initiation of a national Infant and Young Child Nutrition program including the introduction of point-of-use fortification with MNP, the prevalence of iron deficiency and IDA is lower, but the prevalence of vitamin A deficiency is higher.
Authors: Nicole D Ford; Laird J Ruth; Sarah Ngalombi; Abdelrahman Lubowa; Siti Halati; Martin Ahimbisibwe; Rhona Baingana; Ralph D Whitehead; Carine Mapango; Maria Elena Jefferds Journal: J Nutr Date: 2020-04-01 Impact factor: 4.798