To assess the potential contribution of large-scale food fortification (LSFF) towards meeting dietary micronutrient requirements in Tanzania.

We used household food consumption data from the National Panel Survey 2014–15 to estimate fortifiable food vehicle coverage and consumption (standardised using the adult female equivalent approach) and the prevalence at risk of inadequate apparent intake of five micronutrients included in Tanzania’s fortification legislation. We modelled four LSFF scenarios: no fortification, status quo (i.e. compliance with current fortification contents) and full fortification with and without maize flour fortification.

Tanzania.

A nationally representative sample of 3290 Tanzanian households.

The coverage of edible oils and maize and wheat flours (including products of wheat flour and oil such as bread and cakes) was high, with 91 percent, 88 percent and 53 percent of households consuming these commodities, respectively. We estimated that vitamin A-fortified oil could reduce the prevalence of inadequate apparent intake of vitamin A (retinol activity equivalent) from 92 percent without LSFF to 80 percent with LSFF at current fortification levels. Low industry LSFF compliance of flour fortification limits the contribution of other micronutrients, but a hypothetical full fortification scenario shows that LSFF of cereal flours could substantially reduce the prevalence at risk of inadequate intakes of iron, zinc, folate and vitamin B12.

The current Tanzania LSFF programme likely contributes to reducing vitamin A inadequacy. Policies that support increased compliance could improve the supply of multiple nutrients, but the prominence of small-scale maize mills restricts this theoretical benefit.

Family caregivers of persons with ADRD face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected global increase in the number of people with dementia (82 million by 2030 and 152 million by 2050), plus a current Dementia prevalence among persons 60 years and older in Uganda, ranging from 5.5% to 20%, there is paucity of information regarding the psychotherapeutic management of challenges that family caregivers of persons with ADRD go through in many settings in sub-Sahara Africa, including Uganda. This study will contribute to the cultural adaptation of the WHO-iSupport that is an appropriate intervention for caregivers of persons with ADRD in Uganda.

To investigate the current approaches that caregivers use in the support of persons with ADRD, so as to inform the adaptation of the WHO iSupport intervention for Uganda.

This is a cultural adaptation study involving adaptation and pre-test the WHO-iSupport for family caregivers of persons with ADRD in Wakiso, Uganda. We are using a group consensus method that includes a professional translator and independent groups of bilingual experts. Caregivers of patients with ADRD are being recruited into the study. Data will be collected by the researcher and trained research assistants.

The primary outcome of this study is the adaptation of the WHO-iSupport psychotherapy.

Primary analyses will be based on Intention to treat (ITT) principle to avoid any biases that may occur by subjective choice of ineligible subjects. Summary statistics like age will be given as a mean (SD) while for categorical data will be given as a proportion and summarized in tables and graphs.

The proposed study is instrumental as it will be the first known study in our setting that provides a step-by-step guide in the cultural adaptation of an intervention for care giving of persons with ADRD. The A-iSupport is a caregiver focused intervention, that promises better health and care outcomes for family caregivers of persons with ADRD, thus reducing the health care load on mental health workers.

To review existing publications using Household Consumption and Expenditure Survey (HCES) data to estimate household dietary nutrient supply to (1) describe scope of available literature, (2) identify the metrics reported and parameters used to construct these metrics, (3) summarise comparisons between estimates derived from HCES and individual dietary assessment data and (4) explore the demographic and socio-economic sub-groups used to characterise risks of nutrient inadequacy.

This study is a systematic review of publications identified from online databases published between 2000 to 2019 that used HCES food consumption data to estimate household dietary nutrient supply. Further publications were identified by ‘snowballing’ the references of included database-identified publications.

Publications using data from low- and lower-middle income countries.

In total, fifty-eight publications were included. Three metrics were reported that characterised household dietary nutrient supply: apparent nutrient intake per adult-male equivalent per day (n 35), apparent nutrient intake per capita per day (n 24) and nutrient density (n 5). Nutrient intakes were generally overestimated using HCES food consumption data, with several studies finding sizeable discrepancies compared with intake estimates based on individual dietary assessment methods. Sub-group analyses predominantly focused on measuring variation in household dietary nutrient supply according to socio-economic position and geography.

HCES data are increasingly being used to assess diets across populations. More research is needed to inform the development of a framework to guide the use of and qualified interpretation of dietary assessments based on these data.