Background: Insufficient intake of important micronutrients, especially vitamin A, iron
and zinc, as well as high prevalence of anemia, iron deficiency and low zinc status are very
common problems in many parts of Africa. Furthermore, stunting and multiple
micronutrient deficiencies embody additional threats within these communities.
Accordingly, micronutrient malnutrition may be present in the villages of Chamwino and
Kilosa districts of rural Tanzania.
Objectives: The aim of this thesis was to assess the dietary micronutrient intake and its
correlation with blood status and anthropometry of the mothers and children of the rural
areas of Tanzania. In addition the program CIMI (calculator for identification of
micronutrient inadequacy) was assessed in comparison to Nutrisurvey, the standard
nutrition calculation software.
Methods: The ‘Scaling-Up Nutrition’ project tool was used for socio-demographic data
and micronutrient intake assessments (household dietary diversity score (HDDS), food
frequency questionnaire (FFQ) and 24-hour dietary recall). Nutrisurvey and CIMI were
applied to calculate individual micronutrient intakes, which were finally correlated with
anthropometry and available blood micronutrient status.
Results: The Scale-N baseline study included 666 mother-children pairs equally
distributed between the four villages Mzula and Chinoje (Chamwino district, Dodoma) and
Tindiga and Mhenda Kitunduweta (Kilosa district, Morogoro). The women of Kilosa
showed a higher median BMI (23.4 and 22.4 kg/m2) but a lower median height (154 and
153 cm), than the women of Chamwino (BMI: 21.9 and 21.8 kg/m2, height: 154 and 153
cm). Moreover, the women of Kilosa had likewise the higher rates of anemia (44% and
36% vs. 15% and 19%) and iron deficiency (32% and 24% vs. 17% and 15%). Concerning
the children, the highest stunting and anemia rates emerged in Kilosa, whereas the highest
median for vitamin A deficiency prevalence was in Chinoje. The HDDS was higher in
Kilosa (median=6 in both villages) than in Chamwino (median=3 and 4 in Mzula and
Chinoje) and the FFQs revealed that the participants from Kilosa ate more often maize,
rice, sweet potato leaves and beans, while in Chamwino they ate more frequently bulrush
millet, groundnuts and green leafy vegetables.
VI
The 24-hour recalls for both mothers and children showed a higher intake of energy and
macronutrients in Kilosa, but a significantly lower intake of vitamin A and iron than in
Chamwino. Concerning the median zinc intake 75% of all the mothers and/or caregivers
and 95% of all the children did not meet the recommended daily intake (RDI).
Both softwares, Nutrisurvey and CIMI revealed similar results concerning the assessment
of micronutrient intakes, while CIMI correlated slightly better with the blood levels than
Nutrisurvey did.
Conclusion: Anemia and iron deficiency are a severe public health problem in the study
sites especially in Kilosa district. The high intake of starchy foods and the insufficient
intake of animal based protein and micronutrient-rich foods like fruits and vegetables could
be a main cause of the high prevalence of micronutrient deficiencies, anemia and stunting
in rural Tanzania. In order to ameliorate the situation, sustainable interventions, like
educational programs for the women, need to be introduced, to raise the awareness of the
importance of micronutrient-dense foods and how to recognize them adapted to their
residence.