To determine the prevalence and severity of anemia and micronutrient deficiencies among children and women in urban areas of Mozambique prior to the implementation of wheat flour and vegetable oil fortification.
A stratified cross-sectional survey of six main urban centers (Beira, Maputo City, Matola, Nampula/Nacala, Quelimane, Tete) randomly selected children 6-59 months and non-pregnant women 15-49 years of age. Blood samples were collected from children and women to measure hemoglobin concentration, presence of malaria using rapid tests, and deficiency prevalence for iron, vitamin A, vitamin D, folate, and vitamin B12.
Complete data was collected from 962 children and 1086 women. In children, 70.8% were anemic, 19.3% were iron deficient, and 17.3% had iron deficiency anemia; the prevalence of vitamin A deficiency was 18.8%. In women, 39.8% were anemic, 25.1% were iron deficient, and 16.1% had iron-deficiency anemia. About 2% of women had vitamin A deficiency, 2% had folate deficiency, 11% had vitamin B12 deficiency, and 1% and 26% had vitamin D deficiency or insufficiency, respectively. Malaria was rare in children (5%) and women (3%), and was not associated with anemia.
Among urban children and women, anemia is a public health problem. Among children, the prevalence of iron deficiency anemia and vitamin A deficiency are high, and among women, iron deficiency anemia, and B12 deficiency, and vitamin D insufficiency warrant attention. While iron deficiency accounts for some of the anemia prevalence, there are likely other factors contributing to the high anemia prevalence which need further investigation.