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Estimates of Dietary Mineral Micronutrient Supply from Staple Cereals in Ethiopia at a District Level.

ABSTRACT: Recent surveys have revealed substantial spatial variation in the micronutrient composition of cereals in Ethiopia, where a single national micronutrient concentration values for cereal grains are of limited use for estimating typical micronutrient intakes. We estimated the district-level dietary mineral supply of staple cereals, combining district-level cereal production and crop mineral composition data, assuming cereal consumption of 300 g capita^-1 day^-1 proportional to district-level production quantity of each cereal. We considered Barley (Hordeum vulgare L.), maize (Zea mays L.), sorghum (Sorghum bicolor (L.) Moench), teff (Eragrostis tef (Zuccagni) Trotter), and wheat (Triticum aestivum L.) consumption representing 93.5% of the total cereal production in the three major agrarian regions. On average, grain cereals can supply 146, 23, and 7.1 mg capita^-1 day^-1 of Ca, Fe, and Zn, respectively. In addition, the Se supply was 25 µg capita^-1 day^-1. Even at district-level, cereals differ by their mineral composition, causing a wide range of variation in their contribution to the daily dietary requirements, i.e., for an adult woman: 1-48% of Ca, 34-724% of Fe, 17-191% of Se, and 48-95% of Zn. There was considerable variability in the dietary supply of Ca, Fe, Se, and Zn from staple cereals between districts in Ethiopia.

SUBMITTER: Abdu AO

PROVIDER: S-EPMC9459787 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Estimates of Dietary Mineral Micronutrient Supply from Staple Cereals in Ethiopia at a District Level.

Abdu Abdu Oumer AO Kumssa Diriba B DB Joy Edward J M EJM Groote Hugo De H Lark R Murray RM Broadley Martin R MR Gashu Dawd D

Nutrients 20220824 17

Recent surveys have revealed substantial spatial variation in the micronutrient composition of cereals in Ethiopia, where a single national micronutrient concentration values for cereal grains are of limited use for estimating typical micronutrient intakes. We estimated the district-level dietary mineral supply of staple cereals, combining district-level cereal production and crop mineral composition data, assuming cereal consumption of 300 g capita<sup>-1</sup> day<sup>-1</sup> proportional to ...[more]

PMID: 36079728

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Project description:BackgroundIn developing countries most of the edible salts have insufficient iodine content; the problem is worse in Africa. Only 15.4% of the Ethiopian population was using adequately iodized salt. Several factors affect iodine content of edible salt including poor handling practices. The existing evidence isn't sufficient to detail the specific factors at the household level. Therefore, the aim of this study was to determine the iodine content of edible salt and identify factors associated with salt iodine content in Dera District, Northwest Ethiopia.MethodsA community-based cross-sectional study was conducted among 1194 households. A multi-stage sampling technique was used to select the households, and data were collected using the interview. A 50 g salt sample was collected from each selected household and was shipped to the Ethiopian Food, Medicine and Health Care administration and Control Authority (EFMHACA) laboratory center for iodine level analysis. The samples were analyzed using titration method. Data were entered into EPI-INFO and analyzed in SPSS.ResultsOut of 1194 salt samples collected, 57.4% had iodine content in the range 15 ppm to 59.42 ppm. Salt stored in closed containers was more likely to have better iodine content compared to salt stored with open containers (AOR = 1.7, 95% CI: 1.24-2.42). Salt samples stored in dry places were 1.5 times more likely to retain iodine compared to samples stored near to heat/fire or in a moist area (AOR = 1.5, 95% CI: 1.03-2.14). Similarly, salt samples stored for less than 2 months were more likely to have adequate iodine level compared to samples stored for over 2 months (AOR = 1.6, 95% CI: 1.12-2.29).Salt samples obtained from household heads attended primary education (AOR = 1.5, 95% CI: 1.05-2.26), high school (AOR = 1.7, 95% CI: 1.05-2.64), and University (AOR = 2.8, 95% CI: 1.06-5.62) were more likely to have adequate iodine content in edible salt compared to whose didn't attend formal education.ConclusionsNearly three out of five salt samples had enough iodine content. However, this level is low compared to the WHO recommendation (90%). The age, educational status of head of the household, duration of salt storage, use of cover to store salt and knowledge of household heads were associated with an iodine content of salt. Therefore, use of cover and proper storage of edible salt should be encouraged; improving the educational status of the community is essential the edible salt to retain its iodine content at the household level.

Project description:First-level public health facilities (PHFs) serve as primary providers of essential medicines, necessitating critical attention to drug availability and quality assurance. This study aimed to examine the status of functional areas within the drug supply chain management framework and assess the overall capability maturity at first-level PHFs. The cross-sectional study was conducted among 183 drug store sites from six townships of Pyay District. Only situational analysis was exercised to determine the existing situations. The overall capability maturity was determined according to the definitions of levels of the Capability Maturity Module Tool. 58.47% lacked formal drug supply management training, with 23.5% not undergoing performance reviews. Drug forecasting predominantly relied on a pen-paper system (91.6%) and factors like patient load (87.39%), drug consumption (85.71%), and disease prevalence (64.71%). Store site analysis revealed that 65.03% exhibited marginal capability, lacking standardized drugstores and employing unstandardized procedures. Storage practices varied, with 48.69% storing drugs conveniently and others categorizing them by drug type (32.79%) or using the first-expired-first-out system (40.98%). Approximately 42.69% reported having expired drugs. Concerning transportation costs, 37.16% incurred expenses exceeding 20,000 Kyats per time, with management staff often covering the costs. Waste management methods included burial pits (49.18%), incineration (62.84%), and sharp pits (55.19%). A majority (78.14%) used safety boxes, and 57.38% implemented a color-coded system for waste bins. The logistics management information system was entirely paper-based (100%). On average, assessments of drug quality conditions and physical damages scored 46.51% and 48.20%, respectively. The overall supply chain maturity at first-level public health facilities is at a marginal capability level (36.35%). While some basic drug supply chain management procedures were in place, they were not consistently followed, and many systems remain manual. The findings underscored significant inconsistencies in the management functions of supplied drugs, with poor adherence to Standard Operating Procedure guidelines.

Project description:BackgroundModel-based small area estimation methods can help generate parameter estimates at the district level, where planned population survey sample sizes are not large enough to support direct estimates of HIV prevalence with adequate precision. We computed district-level HIV prevalence estimates and their 95% confidence intervals for districts in Uganda.MethodsOur analysis used direct survey and model-based estimation methods, including Fay-Herriot (area-level) and Battese-Harter-Fuller (unit-level) small area models. We used regression analysis to assess for consistency in estimating HIV prevalence. We use a ratio analysis of the mean square error and the coefficient of variation of the estimates to evaluate precision. The models were applied to Uganda Population-Based HIV Impact Assessment 2016/2017 data with auxiliary information from the 2016 Lot Quality Assurance Sampling survey and antenatal care data from district health information system datasets for unit-level and area-level models, respectively.ResultsEstimates from the model-based and the direct survey methods were similar. However, direct survey estimates were unstable compared with the model-based estimates. Area-level model estimates were more stable than unit-level model estimates. The correlation between unit-level and direct survey estimates was (β1 = 0.66, r2 = 0.862), and correlation between area-level model and direct survey estimates was (β1 = 0.44, r2 = 0.698). The error associated with the estimates decreased by 37.5% and 33.1% for the unit-level and area-level models, respectively, compared to the direct survey estimates.ConclusionsAlthough the unit-level model estimates were less precise than the area-level model estimates, they were highly correlated with the direct survey estimates and had less standard error associated with estimates than the area-level model. Unit-level models provide more accurate and reliable data to support local decision-making when unit-level auxiliary information is available.

Dataset Information

Estimates of Dietary Mineral Micronutrient Supply from Staple Cereals in Ethiopia at a District Level.

Publications

Estimates of Dietary Mineral Micronutrient Supply from Staple Cereals in Ethiopia at a District Level.

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