Anaemia prevalence may be reduced among countries that fortify flour
Anaemia prevalence may be reduced among countries that fortify flour
复制标题
DOI：
10.1017/s0007114515001646
复制
发表时间：
2015-07-28
影响因子：
3.6
通讯作者：
Pachon, Helena
中科院分区：
文献类型：
--
作者：
Barkley, Jonathan S.;Wheeler, Kathleen S.;Pachon, Helena
强化面粉在减少贫血症流行方面的有效性不明确。目标是利用现有的国家一级数据，评估在各国开始单独或与玉米粉结合使用至少含有铁、叶酸、维生素A或维生素B-12的小麦粉后，非孕妇贫血症是否减少。通过人口和健康调查报告、世卫组织维生素和矿物质营养信息系统数据库和其他国家一级的营养调查，确定了具有全国代表性的贫血数据。至少进行了两次贫血调查的国家被考虑纳入。在各国内，如果没有一致地调整海拔高度，或者如果抽血部位（例如毛细血管或静脉）或Hb定量方法（例如HemoCue或Cyanmethaemoglobin）不同，则排除调查。使用逻辑回归模型，控制时间效应、人类发展指数（HDI）和地方性疟疾，对有强化前后数据的国家（n 12）和从未强化面粉的国家（n 20）的贫血患病率进行建模。在调整人类发展指数和疟疾后，每年强化与贫血患病率降低2.4%相关（PR 0.976，95% CI 0.975，0.978）。在从未强化的国家中，未观察到贫血患病率随时间推移而降低（PR 0.999，95% CI 0.997，1.002）。在营养强化和非营养强化国家中，人类发展指数和疟疾与贫血显著相关（P
The effectiveness of flour fortification in reducing anaemia prevalence is equivocal. The goal was to utilise the existing national-level data to assess whether anaemia in non-pregnant women was reduced after countries began fortifying wheat flour, alone or in combination with maize flour, with at least Fe, folic acid, vitamin A or vitamin B-12. Nationally representative anaemia data were identified through Demographic and Health Survey reports, the WHO Vitamin and Mineral Nutrition Information System database and other national-level nutrition surveys. Countries with at least two anaemia surveys were considered for inclusion. Within countries, surveys were excluded if altitude was not consistently adjusted for, or if the blood-draw site (e.g. capillary or venous) or Hb quantification method (e.g. HemoCue or Cyanmethaemoglobin) differed. Anaemia prevalence was modelled for countries that had pre- and post-fortification data (n 12) and for countries that never fortified flour (n 20) using logistic regression models that controlled for time effects, human development index (HDI) and endemic malaria. After adjusting for HDI and malaria, each year of fortification was associated with a 2.4% reduction in the odds of anaemia prevalence (PR 0.976, 95% CI 0.975, 0.978). Among countries that never fortified, no reduction in the odds of anaemia prevalence over time was observed (PR 0.999, 95% CI 0.997, 1.002). Among both fortification and non-fortification countries, HDI and malaria were significantly associated with anaemia (P