期刊论文详细信息
BMC Public Health
Prevalence of prenatal zinc deficiency and its association with socio-demographic, dietary and health care related factors in Rural Sidama, Southern Ethiopia: A cross-sectional study
Melaku Umeta3  Fikre Enquselassie1  Samson Gebremedhin2 
[1] School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;College of Agriculture, Hawassa University, Hawassa, Ethiopia;School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
关键词: Serum zinc concentration;    Zinc deficiency;    Maternal nutrition;   
Others  :  1164038
DOI  :  10.1186/1471-2458-11-898
 received in 2011-07-23, accepted in 2011-11-29,  发布年份 2011
PDF
【 摘 要 】

Background

Several studies witnessed that prenatal zinc deficiency (ZD) predisposes to diverse pregnancy complications. However, scientific evidences on the determinants of prenatal ZD are scanty and inconclusive. The purpose of the present study was to assess the prevalence and determinants of prenatal ZD in Sidama zone, Southern Ethiopia.

Methods

A community based, cross-sectional study was conducted in Sidama zone in January and February 2011. Randomly selected 700 pregnant women were included in the study. Data on potential determinants of ZD were gathered using a structured questionnaire. Serum zinc concentration was measured using Atomic Absorption Spectrometry. Statistical analysis was done using logistic regression and linear regression.

Results

The mean serum zinc concentration was 52.4 (+/-9.9) μg/dl (95% CI: 51.6-53.1 μg/dl). About 53.0% (95% CI: 49.3-56.7%) of the subjects were zinc deficient. The majority of the explained variability of serum zinc was due to dietary factors like household food insecurity level, dietary diversity and consumption of animal source foods. The risk of ZD was 1.65 (95% CI: 1.02-2.67) times higher among women from maize staple diet category compared to Enset staple diet category. Compared to pregnant women aged 15-24 years, those aged 25-34 and 35-49 years had 1.57 (95% CI: 1.04-2.34) and 2.18 (95% CI: 1.25-3.63) times higher risk of ZD, respectively. Women devoid of self income had 1.74 (95% CI: 1.11-2.74) time increased risk than their counterparts. Maternal education was positively associated to zinc status. Grand multiparas were 1.74 (95% CI: 1.09-3.23) times more likely to be zinc deficient than nulliparas. Frequency of coffee intake was negatively association to serum zinc level. Positive association was noted between serum zinc and hemoglobin concentrations. Altitude, history of iron supplementation, maternal workload, physical access to health service, antenatal care and nutrition education were not associated to zinc status.

Conclusion

ZD is of public health concern in the area. The problem must be combated through a combination of short, medium and long-term strategies. This includes the use of household based phytate reduction food processing techniques, agricultural based approaches and livelihood promotion strategies.

【 授权许可】

   
2011 Gebremedhin et al; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413125849715.pdf 253KB PDF download
【 参考文献 】
  • [1]Hambidge M: Zinc and Health: Current status and future directions. J Nutr 2000, 130(Suppl):1344-1349.
  • [2]Hotz C, Brown KH: International Zinc Nutrition Consultative Group (IZiNCG) technical document: Assessment of the risk of zinc deficiency in populations and options for its control. Food Nutr Bull 2004, 25(Suppl 1):94-203.
  • [3]Nriagu J: Zinc deficiency in human health. [http:/ / www.extranet.elsevier.com/ homepage_about/ mrwd/ nvrn/ Zinc%20Deficiency%20in%20Humans.pdf] webcite
  • [4]Shah D, Sachdev HP: Effect of gestational zinc deficiency on pregnancy outcomes: Summary of observation studies and zinc supplementation trials. Br J Nutr 2001, 85(Suppl 2):101-108.
  • [5]Caulfield LE, Black RE: Zinc deficiency. In Comparative quantification of health risks: global and regional burden of diseases attributable to selected major risks. Edited by Ezzati M, Lopez AD, Murray CJ, Rodgers A. Geneva: World Health Organization; 2004:257-279.
  • [6]Abebe Y, Bogale A, Hambidge KM, Stoecker BJ, Arbide I, Teshome A, Krebs NF, Westcott JE, Bailey KB, Gibson RS: Inadequate intakes of dietary zinc among pregnant women from subsistence households in Sidama, Southern Ethiopia. Public Health Nutr 2008, 11(4):379-386.
  • [7]Gibson RS, Huddle JM: Suboptimal zinc status in pregnant Malawian women: Its association with low intakes of poorly available zinc, frequent reproductive cycling, and malaria. Am J Clin Nutr 1998, 67:702-709.
  • [8]Ugwuja E, Akubugwo E, Ibiam U, Obodoa O, Ugwu N: Plasma copper and zinc among pregnant women in Abakaliki, Southeastern Nigeria. The Internet J Nutr Wellness 2010., 10(1)
  • [9]Pathak P, Kapil U, Dwivedi S, Singh R: Serum zinc levels amongst pregnant women in a rural block of Haryana State, India. Asia Pac J Clin Nutr 2008, 17(2):276-279.
  • [10]Salimi S, Yaghmaei M, Joshaghani HR, Mansourian AR: Study of zinc deficiency in pregnant women. Iranian J Publ Health 2004, 33(3):15-18.
  • [11]Hayati AW, Rirnbawa H: Food and zinc intake, and determinant of zinc status among pregnant women in Leuwiliang and Cibungbulang Sub-Districts, district of Bogor. Forum Pascasarjana 2002, 25(3):233-253.
  • [12]Haidar J, Umeta M, Kogi-Makau W: Effect of iron supplementation on serum zinc status of lactating women in Addis Ababa, Ethiopia. East Afr Med J 2005, 82(7):349-352.
  • [13]Hambidge M, Abebe Y, Gibson R, Westcott JE, Miller LV, Lei S, Stoecker BJ, Arbide I, Teshome A, Bailey KB, Krebs NF: Zinc absorption during late pregnancy in rural southern Ethiopia. Am J Clin Nutr 2006, 84:1102-1106.
  • [14]Population Census Commission of Federal Democratic Republic of Ethiopia: Summary and statistical report of the 2007 population and housing census of Ethiopia. Addis Ababa 2008., (14)
  • [15]UN emergency unit for Ethiopia: Uncertain food security situation for farmers in Sidama zone. [http://www.ocha-eth.org/Archive/DownloadableReports/SidamaReport062002.pdf] webcite
  • [16]World Bank: Ethiopia country economic memorandum: regional characterization background report. [http://siteresources.worldbank.org/INTETHIOPIA/Resources/ag_growth.pdf] webcite
  • [17]Southern Nations Nationalities and Peoples Regional State: Health and health related demographic information. [http://www.snnprs.gov.et/health.html] webcite
  • [18]Pezzullo JC: Proportion Difference Power/Sample Size Calculation. [http://statpages.org/proppowr.html] webcite
  • [19]Osman K, Åkensson A, Berglund M, Bremme K, Schutz A, Ask K, Vahter M: Toxic and essential elements in placentas of Swedish women. Clin Biochem 2000, 33(2):131-138.
  • [20]Swindale A, Bilinsk P: Household dietary diversity score (HDDS) for measurement of household food access: indicator guide version 2. [http://www.fantaproject.org/downloads/pdfs/HDDS_v2_Sep06.pdf] webcite
  • [21]Coates J, Swindale A, Bilinsk P: Household food insecurity access scale (HFIAS) for measurement of household food access: indicator guide version 3. [http://www.fantaproject.org/downloads/pdfs/HFIAS_v3_Aug07.pdf] webcite
  • [22]International Zinc Nutrition Consultative Group (IZiNCG): Assessing population zinc status with serum zinc concentration: technical brief number 2. [http://www.izincg.org/publications/files/English_brief2.pdf] webcite
  • [23]Earl RO, Woteki CE, Eds: Iron deficiency anemia: recommended guidelines for the prevention, detection and management among US children and women of childbearing age. Washington, D.C.: National Academy Press; 1993.
  • [24]The International Nutritional Anemia Consultative Group (INACG): Adjusting hemoglobin values in program surveys. [http://pdf.usaid.gov/pdf_docs/PNACQ927.pdf] webcite
  • [25]Food and Agriculture Organization of the United Nations: Guidelines for measuring household and individual dietary diversity. [http:/ / www.actioncontrelafaim.org/ fileadmin/ contribution/ 8_publications/ pdf/ Ouvrages_et_fascicules_techniques/ Secu_alimentaire/ Annex_4_FAO_guidelines_dietary_dive rsity_2011.PDF] webcite
  • [26]International Zinc Nutrition Consultative Group (IZiNCG): Quantifying the risk of zinc deficiency: Recommended indicators: Technical brief number 1. [http://www.izincg.org/publications/files/English_brief1.pdf] webcite
  • [27]Kuhnert BR, Kuhnert PM, Zarlingo TJ: Associations between placental cadmium and zinc and age and parity in pregnant women who smoke. Obstet Gynecol 1988, 71(1):67-70.
  • [28]King JC: Determinants of maternal zinc status during pregnancy. Am J Clin Nutr 2000, 71(Suppl 5):1334-1343.
  • [29]Gibson RS, Abebe Y, Stabler S, Allen RH, Westcott JE, Stoecker BJ, Krebs NF, Hambidge KM: Zinc, gravida, infection and iron, but not vitamin B-12 or folate status, predict hemoglobin during pregnancy in Southern Ethiopia. J Nutr 2008, 138:581-586.
  • [30]Ugwuja EI, Akubugwo EI, Ibiam UA, Obidoa O: Maternal sociodemographic parameters: Impact on trace element status and pregnancy outcomes in Nigerian women. J Health Popul Nutr 2011, 29(2):156-162.
  • [31]Gibson RS: Principles of nutritional assessment. 2nd edition. West Corby: Oxford University Press; 1990.
  • [32]Neggers YH, Dubard MB, Goldenberg RL, Tamura T, Johnston KE, Copper RL, Hauth JC: Factors influencing plasma zinc levels in low-income pregnant women. Biol Trace Elem Res 1996, 55(12):127-235.
  • [33]Sandström B: Micronutrient interactions: effects on absorption and bioavailability. Br J Nutr 2001, 85(Suppl 2):181-185.
  • [34]Rossander-Hultén L, Brune M, Sandström B, Lönnerdal B, Hallberg L: Competitive inhibition of iron absorption by manganese and zinc in humans. Am J Clin Nutr 1991, 54:152-156.
  • [35]Solomons NW: Competitive interaction of iron and zinc in the diet: consequences for human nutrition. J Nutr 1986, 116:927-935.
  • [36]O'Brien KO, Zavaleta N, Caulfield LE, Wen J, Abrams SA: Prenatal iron supplements impair zinc absorption in pregnant Peruvian women. J Nutr 2000, 130:2251-2255.
  • [37]Arnaud J, Prual A, Preziosi P, Cherouvrier F, Favier A, Galan P, Hercberg S: Effect of iron supplementation during pregnancy on trace element (Cu, Se, Zn) concentrations in serum and breast milk from Nigerian women. Ann Nutr Metab 1993, 37(5):262-271.
  • [38]Shidfar F, Ameri A, Keshavarz SA, Jalali M: The effects of iron supplementation on serum zinc status of pregnant women. Iranian J Endocrinol Metab 2002, 4(4):249-254.
  • [39]Harvey LJ, Dainty JR, Hollands WJ, Bul VJ, Hoogewerff JA, Robert J, Foxall RJ, McAnena L, Strain JJ, Fairweather-Tait SJ: Effect of high-dose iron supplements on fractional zinc absorption and status in pregnant women. Am J Clin Nutr 2007, 85(1):131-136.
  • [40]Sheldon WL, Aspillaga MO, Smith PA, Lind T: The effects of oral iron supplementation on zinc and magnesium levels during pregnancy. BJOG 2005, 92:892-898.
  • [41]Borna S, Haghollahi F, Golestan B, Norouzi M, Hanachi P, Shariat M, Sarafnejad A, Niroomanesh S: A comparative study of zinc deficiency prevalence in pregnant and non-pregnant women. Tehran Univ Med J 2009, 67(5):360-367.
  • [42]Mohamed AA, Ali AA, Ali NI, Abusalama EH, Elbashir MI, Adam S: Zinc, parity, infection, and severe anemia among pregnant women in Kassla, Eastern Sudan. Biol Trace Elem Res 2010, 140(3):284-290.
  • [43]Chandyo RK, Strand TA, Mathisen M, Ulak M, Adhikari RK, Bolann BJ, Sommerfelt H: Zinc deficiency is common among healthy women of reproductive age in Bhaktapur. Nepal J Nutr 2009, 139:594-597.
  • [44]Wikoff B, Castle MA: Defining maternal depletion syndrome. Am J Public Health 1993, 83(7):1052.
  • [45]Savolainen H: Tannin content of tea and coffee. J Appl Toxicol 1992, 12(3):191-192.
  • [46]Afsana K, Shiga K, Ishizuka S, Hara H: Reducing effect of ingesting tannic acid on the absorption of iron, but not of zinc, copper and manganese by rats. Biosci Biotechnol Biochem 2004, 68(3):584-592.
  • [47]Aldrian PS, Keen CL, Lönnerdal B, Dewey KG: Effects of coffee consumption on iron, zinc and copper status in nonpregnant and pregnant Sprague-Dawley rats. Int J Food Sci Nutr 1997, 48(3):177-189.
  文献评价指标  
  下载次数:2次 浏览次数:6次