RESUMO
Iron deficiency anemia is prevalent among infants in Ghana. This study evaluated the effect of micronutrient-fortified infant cereal on the nutritional status of infants in the La Nkwantanang Municipality of the Greater Accra Region of Ghana, located in western Africa. In this double-blind, controlled trial, infants aged 6-18 months were cluster-randomized to receive either micronutrient-fortified infant cereal containing 3.75 mg iron as ferrous fumarate/50 g cereal (INT; n = 107) or the same cereal without iron (CTL; n = 101) to complement other foods and breast milk. The intervention phase lasted six months followed by a two-month post-intervention phase (with no further study product feeding). Hemoglobin and anthropometry were assessed every 2 months for the 8-month study period. After the 6-month intervention phase, adjusted mean ± standard error change in hemoglobin from baseline in INT and CTL was 1.97 ± 0.19 and 1.16 ± 0.21 g/dl, respectively (p < .01 for each); the increase in hemoglobin was significantly larger in INT versus CTL (increase 0.68 ± 0.30 g/dl; p = .02). Prevalence of anemia declined to a significantly greater extent in INT (84.1% to 42.8%) compared to CTL (89.1% to 62.8%; p = .006). There was no significant difference between groups in weight gain (p = .41) or height gain (p = .21) over the study period. In infants aged 6-18 months, micronutrient-fortified infant cereal consumed for 6 months promoted greater reductions in iron-deficiency anemia, which is a significant public health concern not only in Ghana but also in many developing countries globally.
RESUMO
BACKGROUND: Although breastfeeding of infants is recommended globally, the fact that maternal toxic metal stores are mobilised into breast milk implies infants, whose mothers live and work in mining communities, are at risk of multiple exposure to mining related toxic metals, such as Lead (Pb), Mercury (Hg), Cadmium (Cd) and Arsenic (As), through breast milk intake, in addition to in utero exposure. METHOD: A total of 114 mother-baby pairs, recruited from two community hospitals servicing mining communities in two different regions in Ghana (57 each), were involved in this study. When the babies were 3 months old, the amount of breast milk intake, concentrations of selected toxic metals in the breast milk and therefore the amount of toxic metals exposure through breast milk were determined. The study also, determined the amount of these toxic metals in the hair and urine of each mother-baby pair at 3 months postpartum. RESULTS: Based on the amounts of milk intake and non-milk oral intakes (geometric mean of 0.701 (95% CL 0.59-0.81) Kg/day and median of 0.22 Kg/day respectively), 90% of the babies were determined to have been exclusively breastfed. The amounts of most of the toxic metals in breast milk were higher than the WHO set limits and for 46.4%, 33.3% and 4.4% of the babies, their intake of As, Hg and Pb respectively were above the WHO provisional tolerable daily intake (PTDI) values. CONCLUSION: An appreciable proportion of babies living within the communities served by the Mangoasi Community Hospital in the Obuasi Municipality of the Ashanti Region and the Dompime Health Centre in the Tarkwa Municipality of the Western Region were exposed to Hg, As and Pb through breast milk in excess of what they should and these may have health implication for the infants and therefore calls for interventions.
