Dual fortification of salt with iron and iodine in women and children in rural Ghana.

OBJECTIVE: To test the efficacy of double-fortified salt (DFS) on the anaemia and iodine deficiency (ID) status of women and their children. DESIGN: Double-blind randomised controlled trial. SETTING: Sekyere West District of Ghana. SUBJECTS: In this eight-month trial, mildly anaemic or non-anaemic, non-pregnant, non-lactating women were randomised into three groups receiving: DFS plus weekly placebo (n = 61); iodised salt plus weekly 70 mg iron supplement (n = 65); or iodised salt (IS) plus weekly placebo (control group, n = 58). Correspondingly, their mildly anaemic and non-anaemic children aged 1-5 years were randomised into two groups receiving either the DFS (n = 23) or IS alone (control group, n = 59). RESULTS: At the end of the intervention, prevalence of anaemia in women remained unchanged in the DFS or IS plus weekly iron supplement group, but significantly increased by 19.5% in the control group (P = 0.039). In children, prevalence of anaemia in the DFS group significantly decreased by 21.7% (P = 0.025) while no change was observed in the control group. ID decreased significantly in all groups of women (P < 0.001) and children (P < 0.05), with no difference among groups of women and children. CONCLUSION: While the use of DFS prevented anaemia in women, it had a significant role in both the prevention and treatment of anaemia in children. Both the DFS and IS significantly reduced ID in women and children to a similar degree.

3 beta-Hydroxysteroid dehydrogenase in human placental microsomes and mitochondria: co-solubilization of androstene and pregnene activities.

3 beta-Hydroxysteroid dehydrogenase (3 beta-HSD) was solubilized from human term-placental microsomes and mitochondria using the non-ionic detergent, polyoxyethylene 20 cetyl ether (BrijR-58). Electron photomicrographs showed microsomes and mitochondria well disrupted by the detergent. The pregnene (C-21) and androstene (C-19) activities co-solubilized over a range (0.04-0.44) of BrijR-58/protein (B/P) concentration ratios (w/w). Optimal solubilization of the C-19 and C-21 activities were 63.3 +/- 2.6% (mean +/- SEM) from mitochondria (B/P ratio 0.37) and 71.8 +/- 2.1% from microsomes (B/P ratio 0.34). Detergent treatment of microsomes and mitochondria--varying time (5-90 min, pH 7.4) or varying pH (6.0-7.8, 90 min)--yielded C-19 activities identical with C-21 activities. The C-21/C-19 specific activity ratios of 3 beta-HSD in particulate, solubilized and chromatographed preparations were 2.28 +/- 0.16 (mean +/- SEM) for mitochondria and 1.97 +/- 0.07 for microsomes. 3 beta-HSD molecular weight estimates were 208,000 (microsomes) and 220,000 (mitochondria). These studies argue that a single protein is responsible for both the C-19 and C-21 activities of 3 beta-HSD and that this protein is the same in microsomes and mitochondria.

Zinc nutritional status in preschool children in different communities in southern Ghana.

OBJECTIVE: To determine the nutritional status of preschool children in four communities in Southern Ghana with particular reference to zinc nutritional status, and ascertain whether there are any significant differences in their zinc levels that could explain differences in their nutritional states. DESIGN: Prospective study. SETTING: Four kindergartens--two in rural communities (Kwabenya and Ashalley Botwe) and two in peri-urban communities (Domi and New Achimota) in southern Ghana. SUBJECTS: Preschool children. MAIN OUTCOME MEASURES: The levels of zinc in plasma, hair and red blood cells as well as alkaline phosphatase activity and the various nutritional states of the children as determined by biochemical analyses and anthropometric measurements. RESULTS: The nutritional status of periurban children was better than that of their rural counterparts. Zinc levels were adequate and comparable in both communities and do not correlate to the various nutritional states, as determined by anthropometric and biochemical data. CONCLUSION: Low stature (stunting) can occur in the presence of adequate zinc levels in plasma, hair and red blood cells. Zinc deficiency is not a contributory factor to the present malnutrition of the pre-school children in southern Ghana enrolled in this study.

Endemic goitre and urinary iodine levels in rural communities in the Bolgatanga and Builsa districts of the upper east region of Ghana.

OBJECTIVE: To ascertain the severity of IDD in some rural communities in upper east of Ghana and to urge the establishment of intervention and control measures for IDD. SUBJECTS AND STUDY DESIGN: A total of 1061 subjects, made up of about an equal number of children (8-14 years) and women of childbearing age (15-45 years) from seven Sekoti villages and five Builsa villages of the upper east of Ghana were examined for goitre by the palpation method. In addition, every tenth subject examined, provided urine for urinary iodine determination. RESULTS: 68.8% of the subjects had goitre; 9.9% had visible goitre. The goitre rates of the children from Builsa (77.2%) were significantly higher than those from Sekoti (59.1%) [z = 4.5; p < 0.001]. The overall prevalence of goitre and visible goire in women in the two areas were 70.8% and 15.4% respectively. The women of Sekoti had more goitres (76.6%) but less visible goitres (8.8%) than those of Builsa (63.5% and 21.9%) [p < 0.001). The median urinary iodine level for the two survey areas was 1.6 micrograms/dl. 72% of subjects and urinary iodine less 2 micrograms/dl/24% had urinary iodine levels in the range 2-5 micrograms/dl and the remainder had urine iodine in the range 5-10 micrograms/dl. CONCLUSIONS: These findings indicate severe IDD in Sekoti and Builsa areas requiring urgent action. Further studies are indicated to determine the cause(s) of the IDD endemia.

A preliminary study of serum ferritin reference range in the adult Ghanaian.

Serum ferritin levels were determined in 85 Healthy Ghanaian adults (45 men and 39 women) with a Ciba Corning 125I-Ferritin procedure. Concentrations showed a non-guassian distribution. Values for males ranged from 5.6-273 ng/ml and from 0.74-135 ng/ml for females. The non-guassian nature of the distribution necessitated a logarithmic transformation of the data in order to calculate the serum ferritin reference range (Mean +/- 2SD) for the subjects. The reference range for the males (antilogarithm) was 8.5-306.5 ng/ml (mean = 51.0 ng/ml). The reference range for the Ghanaian women was 3-112 ng/ml (mean = 18.0 ng/ml). The reported reference range for the Caucasian male is 7-350 ng/ml (mean -51.0 ng/ml) and for the Caucasian female, 5-135 ng/ml (mean = 22.0 ng/ml). These Ghanaian reference ranges agree closely with the caucasian values. Data from this preliminary study suggest serum ferritin values of < 8.5 ng/ml and < 3 ng/ml could serve as cut-off points below which iron deficiency may be said to be present in the adult Ghanaian male and female respectively when the same method of analysis is used. A further study of ferritin levels in the Ghanaian is recommended. Pending further work, continued use of the conventional cut-off points of 20 ng/ml for males and 10 ng/ml for females to identify iron-deficient individuals is in order. These conventional cut-off points enhance chances for identifying iron-deficient individuals.

Feasibility of thyroid ultrasonography in field studies in a developing country, Ghana.

This study was carried out to determine the feasibility of using ultrasonography for goitre estimation in the field situation. It is a cross sectional study that was conducted using community based cluster sample. Thyroid sonography was performed on 112 randomly selected school children aged 10 -15 years from two districts in the Greater Accra area of Ghana, using normative values for thyroid volume recommended by WHO/ICCIDD. The mean age of all subjects was 13.5 years+/-0.13 SEM. The male to female ratio was 1:1. The mean height and weight of the children were 1.5 metres+/-0.9 SEM and 38.1 Kg+/-0.7 SEM, respectively. The mean body surface area was 1.27 m2+/-0.2. There were no significant gender differences in their ages (13.6yrs+/-0.2 SEM, 13.4yrs+/-0.1 SEM, respectively) and height (1.50m+/-1.6 SEM, 1.46m+/-1.7 SEM, respectively). The girls (40.0kg+/-1.2 SEM) weighed more than the boys (35.6kg+/-1.1). The mean and median urinary iodine concentration were 82.4+/-8.5 SEM and 67.9 ug/l, respectively. All the children examined had normal thyroid sonogram. The thyroid volumes ranged from 3.6 ml to 15.3ml. The mean thyroid volume was 7.0ml+/-0.2 SEM and the thyroid volume was higher in the girls (7.5ml+/-0.3 SEM) than the boys (6.5ml+/-0.2 SEM). The criteria of thyroid volume per age and sex yielded a goitre prevalence of 1.8 %. In contrast, the criteria of thyroid volume by surface area yielded a goitre prevalence of 8 %. Our study has shown that it is feasible to employ ultrasonography for field studies to determine goitre prevalence in school children in a developing country such as Ghana. However, the best criteria for goitre in children in Ghana, requires to be confirmed in future studies.

The affinity alkylators, 11 alpha-bromoacetoxyprogesterone and estrone 3-bromoacetate, modify a common histidyl residue in the active site of human placental 17 beta,20 alpha-hydroxysteroid dehydrogenase.

Purified human placental 17 beta,20 alpha-hydroxysteroid dehydrogenase (native enzyme) was completely inactivated by the affinity alkylator, estrone 3-bromoacetate, in the presence of cofactor (NADPH). The inactivated enzyme was reactivated to 100% activity by base-catalyzed hydrolysis of the steroidal ester-enzyme conjugate and then repurified by dialysis. Control enzyme in mixtures which contained estrone in place of alkylator was treated the same as the reactivated enzyme. 11 alpha-Bromo[2'-14C]acetoxyprogesterone, an active site-directed affinity alkylator of the enzyme, produced 5.0-fold less radiolabeled 3-(carboxymethyl)histidine and S-(carboxymethyl)cysteine plus 1.4-fold more 1,3-bis(carboxymethyl)-histidine in the reactivated enzyme than in the control enzyme. The lesser amount of S-(carboxymethyl)cysteine and greater amount of 1,3-bis(carboxymethyl)histidine resulted from nonspecific interactions between the reactivated enzyme and the progestin radioalkylator. The nonradiolabeled 3-(carboxymethyl)histidine originally produced by estrone 3-bromoacetate in the enzyme active site hindered radioalkylation of this amino acid by 11 alpha-bromo[2'-14C]acetoxyprogesterone to yield 5-fold less radiolabeled 3-(carboxymethyl)histidine in the reactivated enzyme relative to control enzyme. Thus, the estrogen and progestin affinity alkylators modified a common histidyl residue in the active site. These studies are direct evidence that the estradiol 17 beta-dehydrogenase and 20 alpha-hydroxysteroid dehydrogenase activities reside at a common locus on a single protein.

Reactivation of human placental 17 beta,20 alpha-hydroxysteroid dehydrogenase affinity alkylated by estrone 3-(bromoacetate): topographic studies with 16 alpha-(bromoacetoxy)estradiol 3-(methyl ether).

Estradiol 17 beta-dehydrogenase and 20 alpha-hydroxysteroid dehydrogenase, oxidoreductase activities copurified from the cytosol of human-term placenta as a homogeneous protein (native enzyme), were reactivated at equal rates to 100% activity following complete inactivation in the presence of cofactor (NADPH) with the affinity alkylator estrone 3-(bromoacetate). Reactivation was accomplished by base-catalyzed hydrolysis of steroidal ester-amino acid linkages in the enzyme active site. The rate of enzyme reactivation was pH dependent. In identical studies without NADPH, only 12% of the original enzyme activity was restored. Completely reactivated enzyme was repurified by dialysis. Enzyme in control mixtures (control enzyme) that contained estrone in place of alkylator was treated the same as the reactivated enzyme. Reactivated enzyme exhibited a 6.0-fold lower affinity for common substrates, a 1.8-fold lesser affinity for NAD+ and NADH, and the same affinity for NADP+ and NADPH compared to control enzyme. In incubations that included NADPH, the reactivated enzyme maintained full activity during a 20-h second exposure to estrone 3-(bromoacetate), but in identical incubations without NADPH, the reactivated enzyme was rapidly inactivated at the same rate as the control and native enzymes. The control and reactivated enzymes were inactivated at equal rates by 16 alpha-(bromoacetoxy)estradiol 3-(methyl ether) in the presence or absence of cofactor (NADP+) and exhibited similar Kitz and Wilson inhibition constants for this affinity alkylator. Estrone 3-(bromo[2'-14C]acetate) incubated with native enzyme and NADPH produced radiolabeled 3-(carboxymethyl)histidine and S-(carboxymethyl)cysteine.(ABSTRACT TRUNCATED AT 250 WORDS)