title: Results of Fortification Rapid Assessment Tool (FRAT) surveys in sub-Saharan Africa and suggestions for future modifications of the survey instrument.
abstract: BACKGROUND
  Food fortification has been increasingly recognized as a promising approach to prevent micronutrient deficiencies. The Fortification Rapid Assessment Tool (FRAT) was developed to assist public health program managers to acquire the information needed to implement an effective mass food fortification program. Multiple countries have conducted FRAT surveys, but information on results and experiences with the FRAT tool has been available only at the national level.
  
  
  OBJECTIVE
  To summarize the findings of the FRAT surveys previously conducted in sub-Saharan Africa.
  
  
  METHODS
  Surveys from 12 sub-Saharan African countries (Burkina Faso, Cameroon, Congo, Guinea, Malawi, Mali, Mauritania, Mozambique, Niger, Rwanda, Senegal, Uganda) were identified. Information on consumption patterns for wheat flour, vegetable oil, sugar, and bouillon cubes was reviewed and summarized.
  
  
  RESULTS
  Most surveys found that a moderate to high proportion of women reported consuming wheat flour (48% to 93%), vegetable oil (44% to 98%), sugar (55% to 99%), and bouillon cubes (79% to 99%) in the past 7 days, although consumption was more common and more frequent in urban areas than in rural areas. Similarly, the reported amounts consumed during the previous 24 hours were generally higher in urban settings.
  
  
  CONCLUSIONS
  The FRAT instrument has been successfully used in multiple countries, and the results obtained have helped in planning national food fortification programs. However, the recommended sampling scheme may need to be reconsidered, and the guidelines should be revised to clarify important aspects of fieldworker training, implementation, data analysis and interpretation, and reporting of the results.
authors.affiliation: Program in International and Community Nutrition, Department of Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA. syhess@ucdavis.edu
authors.forename: Sonja Y
authors.initials: SY
authors.lastname: Hess
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Brown
authors.forename: Mawuli
authors.initials: M
authors.lastname: Sablah
authors.forename: Reina
authors.initials: R
authors.lastname: Engle-Stone
authors.forename: Grant J
authors.initials: GJ
authors.lastname: Aaron
authors.forename: Shawn K
authors.initials: SK
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D002675:Child, Preschool; D004034:Diet Surveys / Q000379:methods* / Q000592:standards / Q000639:trends; D019422:Dietary Sucrose; D005260:Female; D005433:Flour; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D018977:Micronutrients / Q000172:deficiency; D008875:Middle Aged; D010938:Plant Oils; D014908:Triticum; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose; D018977:Micronutrients; D010938:Plant Oils