title: Anemia and Micronutrient Status of Women of Childbearing Age and Children 6-59 Months in the Democratic Republic of the Congo.
abstract: Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6-23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24-59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6-23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24-59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6-23 months (23% in SK; 20% in KC), and children 24-59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention.
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. sarah.harvey@ubc.ca.
authors.forename: Sarah
authors.initials: S
authors.lastname: Harvey-Leeson
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. crystal.karakochuk@alumni.ubc.ca.
authors.forename: Crystal D
authors.initials: CD
authors.lastname: Karakochuk
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. meaghanhawes@hotmail.com.
authors.forename: Meaghan
authors.initials: M
authors.lastname: Hawes
authors.affiliation: Faculty of Medicine, University of Goma, Goma, Democratic Republic of the Congo. pltugirimana@gmail.com.|Department of Clinical Biology, College of Medicine and Heath Science, University of Rwanda, Kigali, Rwanda. pltugirimana@gmail.com.
authors.forename: Pierrot L
authors.initials: PL
authors.lastname: Tugirimana
authors.affiliation: Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo. esto.bahizire@gmail.com.|Center of Research in Natural Sciences of Lwiro, Bukavu, Democratic Republic of the Congo. esto.bahizire@gmail.com.
authors.forename: Esto
authors.initials: E
authors.lastname: Bahizire
authors.affiliation: Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. pierretulanefp@gmail.com.
authors.forename: Pierre Z
authors.initials: PZ
authors.lastname: Akilimali
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. kristina.michaux@ubc.ca.
authors.forename: Kristina D
authors.initials: KD
authors.lastname: Michaux
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. larry.lynd@ubc.ca.
authors.forename: Larry D
authors.initials: LD
authors.lastname: Lynd
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. kyly@mail.ubc.ca.
authors.forename: Kyly C
authors.initials: KC
authors.lastname: Whitfield
authors.affiliation: International Food Policy Research Institute, Washington, DC 20006, USA. m.moursi@cgiar.org.
authors.forename: Mourad
authors.initials: M
authors.lastname: Moursi
authors.affiliation: International Food Policy Research Institute, Washington, DC 20006, USA. e.boy@cgiar.org.
authors.forename: Erick
authors.initials: E
authors.lastname: Boy
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. jenniferkfoley@gmail.com.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Foley
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. judy.mclean@ubc.ca.
authors.forename: Judy
authors.initials: J
authors.lastname: McLean
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand. lisa.houghton@otago.ac.nz.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Houghton
authors.affiliation: Department of Human Nutrition, University of Otago, Dunedin 9016, New Zealand. gibson@otago.ac.nz.
authors.forename: Rosalind S
authors.initials: RS
authors.lastname: Gibson
authors.affiliation: Food, Nutrition and Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. tim.green@sahmri.com.|South Australian Health and Medical Research Institute, and the Women's and Children's Health Research Institute, Adelaide 5000, Australia. tim.green@sahmri.com.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000097:blood / Q000453:epidemiology*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology; D001361:Avitaminosis / Q000097:blood / Q000453:epidemiology; D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D003677:Deficiency Diseases / Q000097:blood / Q000453:epidemiology*; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000097:blood; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D018977:Micronutrients / Q000097:blood*; D009752:Nutritional Status; D011990:Receptors, Transferrin / Q000097:blood; D014815:Vitamins / Q000097:blood; D055815:Young Adult; D015032:Zinc / Q000097:blood / Q000172:deficiency*
chemical_list: D006454:Hemoglobins; D018977:Micronutrients; D011990:Receptors, Transferrin; D014815:Vitamins; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron; D015032:Zinc
keywords: Democratic Republic of the Congo; anemia; deficiency; ferritin; hemoglobin; inflammation; iron deficiency; micronutrient