Globally, anemia is a public health problem affecting mostly women of reproductive age (WRA, n = 452) and children aged 6-59 months (n = 452) from low-and lowermiddle-income countries. This cross-sectional study assessed the prevalence and determinants of anemia in WRA and children aged 6-59 months in rural Zimbabwe.The venous blood sample was measured for hemoglobin utilizing a HemoCue machine. Anthropometric indices were assessed and classified based on World Health Organization standards. Socioeconomic characteristics were assessed. The median (±inter quartile range (IQR)) age of WRA was 29 ± 12 years and that for children was 29 ± 14 months. The prevalence of anemia was 29.6% and 17.9% in children and WRA, respectively, while the median (±IQR) hemoglobin levels were 13.4 ± 1.8 and 11.7 ± 1.5 g/dl among women and children, respectively. Multiple logistic regression analysis was used to assess determinants of anemia. Anemia in children was significantly associated with maternal anemia (odds ratio (OR) = 2.02; 95% CI 1.21-3.37; p = .007) and being a boy (OR = 0.63; 95% CI 0.41-0.95; p = .029), while anemia in WRA was significantly associated with the use of unimproved dug wells as a source of drinking water (OR = 0.36; 95% CI 0.20-0.66; p = .001) and lack of agricultural land ownership (OR = 0.51; 95% CI 0.31-0.85; p = .009). Anemia is a public health problem in the study setting. The positive association between maternal and child anemia reflects the possibility of cross-generational anemia. Therefore, interventions that focus on improving preconceptual and maternal nutritional status may help to reduce anemia in low-income settings.

IntroductionSelenium (Se) deficiency is increasingly recognized as a public health problem in sub-Saharan Africa.MethodsThe current cross-sectional study assessed the prevalence and geospatial patterns of Se deficiency among children aged 6–59 months (n = 741) and women of 15–49 years old (n = 831) selected by simple random sampling in rural Zimbabwe (Murewa, Shamva, and Mutasa districts). Venous blood samples were collected and stored according to World Health Organization guidelines. Plasma Se concentration was determined by inductively coupled plasma-mass spectrometry.ResultsMedian, Q1, and Q3 plasma Se concentrations were 61.2, 48.7, and 73.3 μg/L for women and 40.5, 31.3, and 49.5 μg/L for children, respectively. Low plasma Se concentrations (9.41 μg/L in children and 10.20 μg/L in women) indicative of severe Se deficiency risk was observed. Overall, 94.6% of children and 69.8% of women had sub-optimal Se status defined by plasma Se concentrations of <64.8 μg/L and <70 μg/L, respectively.DiscussionHigh and widespread Se deficiency among women and children in the three districts is of public health concern and might be prevalent in other rural districts in Zimbabwe. Geostatistical analysis by conditional kriging showed a high risk of Se deficiency and that the Se status in women and children in Murewa, Shamva, and Mutasa districts was driven by short-range variations of up to ⁓12 km. Selenium status was homogenous within each district. However, there was substantial inter-district variation, indicative of marked spatial patterns if the sampling area is scaled up. A nationwide survey that explores the extent and spatial distribution of Se deficiency is warranted.

Background. Vitamin A deficiency is a public health problem in Zimbabwe. Addressing vitamin A deficiency has the potential to enhance resistance to disease and reduce mortality, especially in children aged <5 years. Objective. To describe a vitamin A supplementation outreach strategy implemented in one of the remote rural districts in Zimbabwe, which increased coverage after being implemented in difficult circumstances in a remote rural region. Methods. We implemented and adapted a vitamin A supplementation outreach strategy within the national immunisation days (NIDs) and extended programme of immunisation in a remote rural district in Zimbabwe. The strategy involved supplementating children at prescheduled outreach points once per month for the whole year. Despite usual operational challenges faced at implementation, this approach enabled the district to increase delivery of vitamin A supplements to young children in the district. Results. The strategy covered 63 outreach sites, with two sites being covered per day and visited once per month for the whole year. Coverage reached 71% in an area in which previous coverage rates were around <50%. Conclusion. Implementing a vitamin A supplementation outreach strategy increased vitamin A supplementation coverage among child ren living in a remote rural region. This strategy can potentially be used by Scaling Up Nutrition (SUN) member states. However, we recommend further exploration of this strategy by others working in similar circumstances. S Afr J CH 2014;8(2):6467.

Background Kondo Rural Health Centre recorded 27 malaria patients between the 27th of January 2019 and the 2nd of February 2019 against an epidemic threshold of 19 with the malaria outbreak being confirmed on the 5th of February 2019. Indoor residual spraying as part of integrated vector management control activities had been done in the district before the onset of the rainy season as well as social behaviour change communication but residents were contracting malaria. We, therefore, investigated the risk factors associated with this outbreak to recommend scientifically effective prevention and control measures. Methods We conducted a 1:1 unmatched case-control study. A case was a resident of Mudzi from the 4th of February 2019 who had a positive rapid diagnostic test for malaria randomly selected from the clinic’s line list whilst controls were randomly selected from the neighbourhood of cases. Pretested interviewer-administered questionnaires were used to collect information on demographic characteristics, knowledge and practices of residents in malaria prevention. Data were analysed using Epi info 7. Results A total of 567 confirmed malaria cases was recorded with an overall attack rate of 71.7 per 1000 population. Sixty-three case-control pairs were interviewed. The majority of cases 78% (49/63) were from Makaza, Chanetsa and Nyarongo villages which are within 3 km from Vhombodzi dam. A stagnant water body near a house [aOR = 8.0, 95%CI = (2.3–28.6)], engaging in outdoor activities before dawn or after dusk [aOR = 8.3, 95%CI = (1.1–62.7)] and having a house with open eaves [aOR = 5.4, 95%CI = (1.2–23.3)] were independent risk factors associated with contracting malaria. Wearing long-sleeved clothes when outdoors at night [aOR = 0.2, 95%CI = (0.1–0.4)] was protective. Conclusion A stagnant water pool close to the homestead and engaging in outdoor activities before dawn and after dusk were modifiable risk factors associated with the malaria outbreak despite the community being knowledgeable on the transmission and prevention of malaria. Community sensitisation and mobilisation in the destruction of stagnant water bodies and cutting of tall grass around homesteads were recommended measures to contain the outbreak.

Objective: This paper explores lessons learnt from national health policies, strategies and nutrition interventions introduced in Zimbabwe post-independence to address the burden of micronutrient deficiencies. Methods: A desk review was conducted on national policies, and strategies to improve micronutrient status. The paper highlights key achievements, challenges, opportunities; and finally closes by highlighting current and future policy and intervention issues related to micronutrient deficiencies. Results: Great progress has been made towards addressing iodine deficiency, VAS (vitamin A supplementation) in children, iron folate among pregnant and lactating mothers, and establishing regulatory frameworks for food fortification. Initial findings from multi-sector nutrition interventions show great potential for the reduction of micronutrient deficiencies. Current micronutrient interventions need scaling up and strengthening. Nutrition advocacy and communication has remained limited and this is negatively impacting on demand driven programming for the control of micronutrient deficiencies. Conclusions: Strong partnerships within and outside government are needed to influence multisectoral programming and coordination mechanisms. Strong connections and linkages with agriculture, social protection, health and education are needed for optimal integrated nutrition sensitive programming to ensure sustainable access to micronutrient rich foods. High level government commitment at the national level is necessary for strong multi-disciplinary nutrition programming.