Abstract
Fortification of wheat flour with iron and folic acid became mandatory in Ivory Coast in 2007. The purpose of this study was to determine the time trend relation between mandatory double fortification of wheat flour with iron and folic acid and markers and prevalence of anemia by comparing the data between pre- and post-fortification periods in Ivory Coast children. Data were derived from the pediatric unit of the University Hospital of Treichville, Abidjan, Ivory Coast. Medical records of 467 children from 5 to 14 years old were analyzed from the years 2004 through 2010. Periods from 1 January 2004 to 31 December 2006 and 1 January 2008 to 31 December 2010 were considered as pre- and post-fortification periods, respectively. Data on hemoglobin, hematocrit, red blood cell count (RBC), mean corpuscular volume (MCV), and anemia between pre- and post-fortification periods were compared. There were no significant differences in hemoglobin, hematocrit, RBC, and prevalence of anemia between pre- and post-fortification periods. However, MCV in post-fortification period was significantly higher compared to pre-fortification period in all subjects (77.6 fL vs. 76.8 fL; p = 0.02) and in young girls (79.1 fL vs. 75.2 fL; p = 0.01). Lack of significant differences in anemia and in markers of anemia between pre- and post-fortification periods need further investigation in children of Ivory Coast.
Highlights
Anemia from micronutrient deficiencies is a major public health problem in developing countries such as Ivory Coast [1]
We reported the first data on a temporal association between double fortification of wheat flour with iron and folic acid, and anemia and makers of anemia in
We compared the differences between the pre-fortification period
Summary
Anemia from micronutrient deficiencies is a major public health problem in developing countries such as Ivory Coast [1]. Anemia is caused by other nutritional deficiencies, bacterial and viral infections, inflammation, and parasitic infestations [2]. Anemia affects nearly 2 billion people across the world [3]. The prevalence of anemia is estimated at 43%, while it is at 9% in developed countries [4]. Mild to moderate anemia leads to weakened immunity, reduced work capacity, reduced cognitive function, and an overall decreased quality of life. Severe anemia is considered a major cause of maternal and infant morbidity and mortality in developing countries [5]
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