Browsing by Author "Mshanga, Naelijwa"

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A Cross‐Sectional Association Between Serum Aflatoxin and Micronutrient Status Among Children Aged 6–24 Months in Rural Tanzania
(John Wiley & Sons, Ltd., 2025) Mshanga, Naelijwa; Kassim, Neema; Suchaya Sonto; Haikael, Martin; Pirani, Monica; Sally Moore; Auma, Carolyn; Kimanya, Martin; Yun Yun Gong
Micronutrient deficiencies are a significant public health problem, particularly affecting children under five, caused by inadequate intake of micronutrient‐rich foods or environmental factors like aflatoxin exposure. Three hundred sixty‐nine children aged 6–24 months from Tanzania's Babati and Hanang districts participated in this study. Serum aflatoxin albumin adduct (AF‐alb) levels were assessed as measures of aflatoxin exposure. Haemoglobin levels, serum ferritin, C‐reactive protein, zinc and vitamins A, B9, and B12 were assessed to determine anaemia and deficiencies in iron, zinc and vitamins A, B9 and B12 based on WHO cut‐off points. Seventy per cent of the children had detectable levels of AF‐alb. The AF‐alb geometric mean was 5.99 (95% CI: 5.99, 6.87) pg/mg. Of those with measured micronutrient markers, 37% were anaemic, and 33%, 75%, 4%, 4% and 73% were deficient in iron, zinc, vitamins A, B9 and B12, respectively. The child's age, gender and stunting were all significantly associated (p < 0.05) with anaemia and deficiencies in zinc, vitamin A and B12. Moreover, AF‐alb was associated with iron deficiency even after adjusting for confounders; children with high AF‐alb levels ( > 6.07 pg/mg) were 1.40 times more likely to be iron deficient (AOR = 1.40, 95% CI: 1.11, 1.74). The high prevalence of micronutrient deficiencies and its association with aflatoxin exposure among young children highlights the urgent need for comprehensive intervention strategies, such as improving dietary diversity and enhancing food safety to reduce aflatoxin exposure. Importantly, longitudinal research is needed to understand the causal effect relationship between aflatoxin exposure and micronutrient deficiencies.
Association Between Aflatoxin Exposure and Haemoglobin, Zinc, and Vitamin A, C, and E Levels/Status: A Systematic Review
(MDPI, 2025-02-28) Mshanga, Naelijwa; Moore, Sally; Kassim, Neema; Martin, Haikael; Auma, Carolyn; Gong, Yun
Background: Aflatoxin, produced by Aspergillus flavus and Aspergillus parasiticus fungi, contaminates a broad range of crops such as maize, nuts, and cotton. Aflatoxin exposure causes growth failure, immune suppression, and liver cancer. While several systematic reviews have assessed the link between aflatoxin exposure and growth development in humans, there is a lack of reviews on the associations between aflatoxin exposure and micronutrient levels/status. This review addresses that gap by compiling studies on the association between aflatoxin exposure and micronutrient levels/status in humans. Methods: A comprehensive search of the SCOPUS, PUBMED, EMBASE, and Web of Science databases was conducted, focusing on studies published between 2003 and 2023. Only English-language studies using urine, blood, serum, or plasma biomarkers were included to assess the exposure and outcomes. The risk of bias in these studies was evaluated using the Academy of Nutrition and Dietetics Quality Criteria for human studies. Results: Ten observational studies were included in the systematic review, which collectively reported the association between aflatoxin exposure and haemoglobin, zinc, and vitamin A, E, and C levels. This review suggests that aflatoxin exposure is associated with micronutrient deficiencies, such as anaemia (low haemoglobin levels (<11 g/dL)) in pregnant women and vitamin A deficiency in adults and children. Conclusions: This review highlights the link between aflatoxin exposure and micronutrient deficiencies, emphasizing the need for aflatoxin mitigation within micronutrient interventions. Future studies should focus on longitudinal and interventional research to establish causal relationships and assess the effectiveness of mitigation strategies. Additionally, further research is needed to explore the interaction between aflatoxin exposure and other potential confounding factors such as dietary patterns, socioeconomic status, and genetic predisposition.
Food-basket intervention to reduce micronutrient deficiencies among Maasai-pregnant women in Tanzania: a quasi-experimental study.
(Journal of Human Nutrition and Dietetics, 2019-05-26) Mshanga, Naelijwa; Martin, H; Petrucka, P
Background Micronutrients comprised of vitamin and mineral nutrients that are needed during pregnancy for foetal growth, development and maturation, as well as for reducing/preventing maternal complications. However, micronutrient‐rich foods (vegetables and fruits) are lacking in the Ngorongoro Conservation Area as a result of restrictions on cultivation in conservation areas and the unavailability of vegetables and fruits in local markets. The present study introduced a food basket intervention and assessed the effectiveness of the food baskets with respect to addressing anaemia, vitamin A and iron deficiencies among pregnant Maasai women within the Ngorongoro Conservation Area. Methods The quasi‐experimental study included Misigiyo ward as a control group (provided education only) and Olbalbal ward as an intervention group (provided food baskets and education). The study assessed haemoglobin, serum ferritin and retinol at baseline and during follow‐up. Haemoglobin, serum ferritin and retinol were quantitatively (duplicate) measured with HemoCue™ (HemoCue AB, Ängelholm, Sweden), Maglumi 800 (Snibe Diagnostic, Shenzhen, China) and vitamin A enzyme‐linked immunosorbent assay, respectively. Dependent and independent t‐tests were used to compare the micronutrient blood levels between and within the groups. Results The present study found a statistically significant increase in serum retinol (P < 0.001) in the intervention group compared to the control group; moreover, baseline serum retinol was positively associated with the follow‐up serum retinol, whereas baseline haemoglobin and serum ferritin were negatively associated. Conclusions The food basket intervention holds promise with repect to reducing micronutrient deficiency, especially in communities where micronutrient‐rich foods are scarce.
Indigenous vegetables: a sustainable approach to improve micronutrient adequacy in Tanzanian women of childbearing age
(Springer Nature, 2021-02-02) Conti, Maria; Giuseppe, Rachele; Monti, Maria; Mkindi, Angela; Mshanga, Naelijwa; Ceppi, Silvia; Msuya, John; Cena, Hellas
Background/objectives Increasing dietary diversity is a viable strategy for addressing micronutrient malnutrition in women of childbearing age (WCA) from low-income countries. Recently, it has been demonstrated that some indigenous vegetables (IV) with high nutrient density may help to ameliorate micronutrient’s intake. The Minimum Dietary Diversity index for Women (MDD-W) could be considered as a proxy to describe one important dimension of women’s diet quality. This cross-sectional study aimed at exploring aspects contributing to micronutrients adequacy in Tanzanian WCA, with a focus on IV consumption and other socio-demographic factors. Subjects/methods Data collection was conducted among urban and peri-urban women in Arusha city, Tanzania. Socio-demographic factors were collected using a structured interview. Information on IV consumption and MDD-W calculation were obtained using a 24-h recall. Results One-hundred and forty-one women aged 14–49 years were interviewed. Sixteen per cent of the sample consumed at least one portion of IV/day. The total median MDD-W was 4.0 (IQR. 3.0–5.0) and it was adequate in the 44% of the sample. Women who consumed IV had MDD-W 0.66 points (95% CI: 0.02–1.30, p = 0.046) higher than those who did not; consuming IV had an odds ratio of more than three times concerning women not consuming IV (OR: 3.30, 95% CI: 1.24–8.81, p = 0.017). Conclusions The IV consumption is positively associated with micronutrient adequacy and its absence from the diet can be an indicator of micronutrient deficiencies in vulnerable people such as WCA. For that reason, this study suggests that IV consumption may improve micronutrient deficiency in WCA.
Knowledge and Dietary Practices on Vitamin A and Iron Among Maasai Pregnant Women: A Mixed-Method Study, Ngorongoro, Tanzania
(Dovepress, 2020-09-18) Mshanga, Naelijwa; Martin, Haikael; Petrucka, Pammla
Background: Provision of micronutrients knowledge is important during pregnancy as it informs mothers what to eat and avoid, to ensure sufficient micronutrient absorption by the mothers and fetuses. Most studies focus on general nutrition knowledge and dietary prac tices, but there is minimal known about micronutrient knowledge especially in pastoral societies. Therefore, the aim of this study was to explain the current micronutrient knowl edge and dietary practices of pregnant women in this unique pastoral society. Methods: This is a mixed-method study that involves focus group discussions and question naires in assessing the micronutrient knowledge and frequency micronutrients dietary practices of Maasai pregnant women from one week to thirty-six weeks pregnant. Chi-square test and descriptive statistics, such as percentages, frequency distribution and measures of central tendency, were used to assess socio-demographic data, micronutrients knowledge and frequency of micronutrients dietary practices and the comparison between knowledge and dietary practices, while inductive thematic content analysis was used to analyze qualitative data. Results: In total, 140 questionnaires were completed with a response rate of 100% and 32 participants drawn from this group attended one of four focus group discussions. The study found that most participants had good knowledge of dietary iron, while less than a quarter (24.3%) had good knowledge of vitamin A. Moreover, there was a statistical significance difference (P=0.043) between knowledge and dietary practices. Low dietary micronutrient intake was primarily due to cultural restrictions, prohibition in cultivating and unavailability of micronutrients rich foods in this geographical area. Conclusion: The majority of the study participants had good knowledge of iron compared to vitamin A; however, they do not translate the knowledge in dietary practices. Therefore, the Government of Tanzania through Ministry of Education and Health should introduce different interventions to increase micronutrients knowledge and practices in pastoral societies.
Prevalence and Factors Associated with Anaemia and Undernutrition Among Children Aged 6–24 Months in Rural Tanzania
(MDPI, 2025-06-19) Mshanga, Naelijwa; Moore, Sally; Kassim, Neema; Auma, Carolyn; Gong, Yun Yun; Martin, Haikael
Background: Anaemia and undernutrition remain a significant public health problem in low and middle-income countries (LMICs), particularly affecting under-five children. In Tanzania, the prevalence of anaemia and undernutrition in under-five children is still high; however, less is known about the prevalence and predictors of these conditions in rural areas. Therefore, the current cross-sectional study presents the prevalence and determinants of anaemia and undernutrition among 457 children aged 6–24 months in the Babati and Hanang districts of Tanzania. Method: Haemoglobin concentration was assessed through capillary blood samples. Anaemia was classified according to WHO 2011 guidelines using a cut-off of <11.0 g/dL for children under five, while the WHO 2006 growth indicators were used to classify the nutritional status (i.e., stunting, wasting and underweight). Results: The results from this study show that 32%, 32%, 20% and 4% of children aged 6–24 months were anaemic, stunted, underweight and wasted, respectively, while only 33% had an adequate minimum dietary diversity (MDD). In addition, the child’s age (13–24 months) was significantly associated with anaemia (AOR: 2.1 95% CI 1.4, 3.1), stunting (AOR:17.4 95% CI 10.3, 29.4) and underweight (AOR: 15.9 95% CI 7.9, 32.0). Moreover, male children were three times more likely to be wasted (AOR: 3.5 95% CI 1.1, 10.9) than their female counterparts. Anaemia and stunting were the most prevalent nutritional disorders among 6–24-month-old children in the Hanang and Babati districts. Moreover, age (13–24 months) was found to be the common predictor for anaemia, stunting and underweight. Conclusion: The observed association between age and anaemia, as well as undernutrition, suggest that age may be an essential factor when designing nutrition-related programs in similar rural settings.