| In preparation for a proposed large-scale food fortification program in Cameroon, we completed a nationally-representative, cross-sectional cluster survey to assess the prevalence of micronutrient deficiencies among women of reproductive age and children 12--59 months of age (n=1002 households). We also measured the consumption patterns of four potentially fortifiable foods (refined vegetable oil, wheat flour, sugar, and bouillon cube). Anemia (39% of women, 58% of children) and deficiencies of iron (15--32%, 21--70%), zinc (77%, 70%), and vitamins A (22%, 35%) and B-12 (28%, 27%) were common, especially in the North region and among households (HH) with lower socio-economic status. Oil was consumed by 54% of HH, whereas >75% of HH consumed wheat flour, sugar, and bouillon cube. Median intakes of oil, wheat flour, sugar, and bouillon cube (among consumers) were 19.8, 79.4, 30.0 and 1.9 g/day for women and 12.0, 49.4, 19.4 and 0.9 g/day for children, respectively.;We also explored the use of plasma retinol-binding protein (RBP), rather than plasma retinol (ROH), as a population-level indicator of vitamin A (VA) status in a subsample of women (n=121) and children (n=123). Overall, RBP was an excellent predictor of low plasma retinol concentrations. Because RBP concentrations were consistently higher than those of retinol, we derived population-specific RBP cutoffs to indicate VA deficiency: <1.17 mumol RBP/L for women (corresponding to <1.05 mumol ROH/L) and <0.83 mumol RBP/L for children (corresponding to <0.70 mumol ROH/L).;Finally, we compared the prevalence and distribution of iron deficiency (ID) and iron-deficiency anemia (IDA) among Cameroonian women (n=872) and children (n=838) as measured by plasma ferritin, soluble transferrin receptor, body iron stores, and hemoglobin, and evaluated the impact of adjustments for inflammation/infection on these measures. The prevalence of ID ranged from 11.5--31.9% among women and 14.2--68.4% among children, and the prevalence of IDA ranged from 9.0--19.2% among women and 11.9--47.4% among children, depending on the iron status indicator. Although use of the different iron indicators resulted in varied estimates of the prevalence of ID and IDA, the indicators generally identified similar groups at highest risk of deficiency. |
