Journals

Permanent URI for this collection

http://41.93.62.172:4000/handle/123456789/159

Browse

Browsing Journals by Subject "Anaemia"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Effect of micronutrient fortified beverage on nutritional anaemia during pregnancy
    (East African medical journal, 2002) Ndossi, Godwin D.
    Objective: To evaluate the efficacy of a multiple micronutrient fortified beverage containing eleven nutrients at physiological levels in prevention of anaemia and improving iron and vitamin A status during pregnancy. Design: A randomised double blind placebo controlled study. Setting: Mpwapwa and Kongwa Districts in Dodoma Region of Tanzania. Subjects: Five hundred and seventy nine pregnant women were screened for entry into the study and 439 women who met the study criteria were enrolled. Interventions: Study participants received either a fortified (F) or non-fortified (NF) orange flavoured drinks identical in appearance, provided in two self administered servings per day for an eight week period. Main outcome measures: Comparison of haemoglobin (Hb), serum ferritin (SF) and serum retinol (SR) at baseline and follow up. Results: After eight weeks of supplementation, the F group (n=129) had a significantly higher Hb increase of 0.86g/dL compared to 0.45gldL in the NF group (n=130) pe0.0001. Gestational age at entry into the study, moderated the effect on Hb of the fortified drink. Women at earlier gestational age upon entry, had a higher rise in Hb than women of late gestational age (OSg/dL versus 0.04 g/dL rise respectively, p=0.038, n=188). The risk of being anaemic at the end of the study for those in the F group was reduced by 51% (RR=0.49, CI=0.28 to 0.85). Iron stores (by serum ferritin levels) increased by 3pgL in the F group (p=0.012) and a decrease of 2Clgn in the NF group (p=0.115). The follow up ferritin concentration depended on initial ferritin level. Regardless of treatment group, serum retinol concentrations were significantly higher in mothers who had delivered. Mothers who had adequate levels at entry benefited more from the supplement than those with low levels (0.26 pmoVL versus no significant difference). Conclusions: The multiple micronutrient-fortified beverage given for eight weeks to pregnant women improved their haemoglobin, serum ferritin and retinol status. The risk for anaemia was also significantly reduced. The important predictors of Hb increase at follow up were the fortified beverage, baseline Hb, serum retinol, baseline ferritin and gestational age at entry into study. Anthropological research showed that the beverage was highly acceptable and well liked.
  • Thumbnail Image
    Item
    Helicobacter pylori is not a Cause of Anaemia amongst People Living with HIV and AIDS in Tanzania
    (European Journal of Nutrition & Food Safety, 2015) Ndossi, Godwin D.
    Objectives: Helicobacter pylori is the most common infection worldwide. Several reports have indicated an association between H. pylori infection and anaemia. The aim of the study was to determine the prevalence of H. pylori co-infection with HIV and its correlation with anaemia and CD4 cell counts. Methods: A cross sectional study of 77 people infected with human immunodeficiency virus at SHIDEPHA+ Post Test Club Mwananyamala in Dar-es-Salaam, were assessed for Helicobacter pylori infection using 13C urea breath tests, immune integrity by use of CD4 cell count and anaemia using Beckman Coulter Counter. Results: Of the 77 subjects who were HIV positive 31 (40%) were H. pylori positive, compared to 14 out of 25 (56%) H. pylori positive amongst HIV negative controls. The mean (SD) haemoglobin level in H. pylori negative subjects was 11.7 (1.6) g/dl, compared to 11.4 (1.75) g/dl amongst those who were H. pylori positive (unpaired t test, p=0.43). Of the 15 subjects with CD4 counts below 200/ml, 4 (26%) were H. pylori positive, compared to 27/62 (48%) of those with CD4 counts above 200/ml (Chi squared, p<0.005). Conclusion: Our data demonstrates that H. pylori colonization is unlikely to contribute to anaemia amongst HIV positive subjects studied. Although this suggests that H. pylori colonization does not lead to significant problems in this population, both adequate nutrition and treatment of problems such as iron deficiency remain important components of the management of HIV positivity and AIDS throughout Africa.
  • Thumbnail Image
    Item
    Impact of dietary iron intake on anaemia in Tanzanian schoolchildren
    (South African Journal of Clinical Nutrition, 2004) Ndossi, Godwin D.
    Objective. To investigate the nutritional relationship between dietary intake and prevalence of anaemia among Tanzanian schoolchildren. Methods. Dietary intakes of 101 schoolchildren aged 7 - 12 years were assessed using a pre-tested food frequency questionnaire. Haemoglobin (Hb), haematocrit, erythrocyte protoporphyrin (EP) and serum ferritin (SF) were used to determine their anaemia and iron status. Other socio-economic variables were collected using a profile questionnaire. Results. Significantly lower intake of iron was seen in 48% of schoolchildren with Hb < 11.5 g/dl (anaemic) compared with those who were normal. Total iron intake was 22 ± 7 and 27 ± 13 mg/day respectively (p < 0.05). There was a general poor intake of iron from animal sources in all children. A higher iron intake was found in schoolchildren with normal iron status (by EP and SF levels) than in those who were not normal (26 ± 11 mg/day v. 22 ± 9 mg/day, p < 0.05). Iron deficiency was found in 45% of schoolchildren (N = 80) and 31% were categorised as having iron deficiency anaemia. The mean energy intake in boys was higher than in girls (2 150 ± 770 v. 1 830 ± 895 kcal/day respectively). Boys also had a higher intake of ascorbic acid (50 ± 32 v. 31 ± 23 mg/day, p > 0.05). In stepwise multiple regression analysis, daily iron intake remained the most significant nutrient predicting for Hb status. There was a significant correlation between iron intake and serum ferritin (r = 0.233, p < 0.05). Conclusion. Iron intake in this Tanzanian community is inadequate for maintaining normal iron nutrition. The factors contributing to the inadequacy include consumption of foods with low iron bioavailability. Food-based intervention should be one of the important strategies for reducing the magnitude of the problem of anaemia in this community.
  • Thumbnail Image
    Item
    Vitamin A supplementation and other predictors of anemia among children from Dar Es Salaam, Tanzania
    (The American journal of tropical medicine and hygiene, 2000) Ndossi, Godwin D.
    The associations of hemoglobin, hematocrit, and packed cell volume with socioeconomic factors, malaria, human immunodeficiency virus (HIV) infection, and nutritional status were examined among 687 children admitted to hospital with pneumonia participating in a double blind, placebo-controlled trial of vitamin A supplementation. Children were randomized to receive 2 doses of vitamin A (200,000 IU) or placebo at baseline, and additional doses at 4 and 8 months after discharge from hospital. Hemoglobin levels were measured at enrollment and, on a subset of 161 children, during follow-up. At baseline, hemoglobin concentration was positively associated with the number of possessions in the household, maternal level of education and quality of water supply, and inversely related to malaria infection after controlling for potential confounding variables. Children infected with HIV experienced a significant fall in mean hemoglobin levels over time. The risk of developing severe anemia (< 7 g/dL) during follow-up was lower for children who were breastfed for longer than 18 months as compared to those with less than 6 months of breastfeeding (adjusted prevalence ratio = 0.14, 95% confidence interval [CI] = 0.02, 0.93; P = 0.04), and higher for children over two years of age as compared to 6 to 11 months-old infants (adjusted prevalence ratio = 8.11, 95% CI = 1.2, 55.8; P = 0.03). Children with repeated diagnoses of malaria had 4.1 times the risk of developing severe anemia than did children without the diagnosis (95% CI = 1.3, 13.5; P = 0.02). Vitamin A supplements were associated with an overall nonsignificant reduction of 14% in the risk of developing severe anemia (adjusted prevalence ratio = 0.86, 95% CI = 0.37, 1.99; P = 0.73). We conclude that malaria, HIV infection, low socioeconomic status, and short duration of breastfeeding are strong and independent determinants of adverse hematologic profiles in this population.