Micronutrient Deficiencies among Breastfeeding Infants in Tanzania.

Alexandra Bellows,Christopher Sudfeld,Alfa Muhihi,Emily Smith,Salum Mshamu,Ramadhani Noor,Wafaie Fawzi,Honorati Masanja,Christina Briegleb

doi:10.3390/nu9111258

Abstract

Infant mortality accounts for the majority of child deaths in Tanzania, and malnutrition is an important underlying cause. The objectives of this cross-sectional study were to describe the micronutrient status of infants in Tanzania and assess predictors of infant micronutrient deficiency. We analyzed serum vitamin D, vitamin B12, folate, and ferritin levels from 446 infants at two weeks of age, 408 infants at three months of age, and 427 mothers three months post-partum. We used log-Poisson regression to estimate relative risk of being deficient in vitamin D and vitamin B12 for infants in each age group. The prevalence of vitamin D and vitamin B12 deficiency decreased from 60% and 30% at two weeks to 9% and 13% at three months respectively. Yet, the prevalence of insufficiency at three months was 49% for vitamin D and 17% for vitamin B12. Predictors of infant vitamin D deficiency were low birthweight, urban residence, maternal education, and maternal vitamin D status. Maternal vitamin B12 status was the main predictor for infant vitamin B12 deficiency. The majority of infants had sufficient levels of folate or ferritin. Further research is necessary to examine the potential benefits of improving infants’ nutritional status through vitamin D and B12 supplements.

Highlights

In 2015, the global under-five mortality rate was estimated to be 41 deaths per 1000 livebirths and the neonatal mortality rate was estimated to be 18 deaths per 1000 livebirths; many low- and low-middle income countries have significantly higher rates [1]
A total of 446 infants were sampled at two weeks old, 408 infants sampled were at three months old, and 427 mothers were sampled at three months postpartum
A total of 13% of infants sampled at two weeks and 17% of infants sampled at three months were born preterm

Summary

Introduction

In 2015, the global under-five mortality rate was estimated to be 41 deaths per 1000 livebirths and the neonatal mortality rate was estimated to be 18 deaths per 1000 livebirths; many low- and low-middle income countries have significantly higher rates [1]. Development Goals (SDGs), significant reductions in under-five mortality and neonatal mortality must be achieved [2]. Despite progress in reducing child mortality in Tanzania, neonatal and infant mortality still accounts for the majority of child deaths [3,4]. Tanzania’s under-five mortality was 60 deaths per 1000 livebirths and neonatal mortality rate was 22 deaths per 1000 livebirths in 2015 [1]. Understanding the relative importance of underlying causes of neonatal and post neonatal death is important for identifying high impact interventions.

Objectives

Results

Discussion

Conclusion