A Cross-Sectional Study on the Diet and Nutritional Status of Adolescent Girls in Zambézia Province, Mozambique (the ZANE Study): Design, Methods, and Population Characteristics

Abstract

BackgroundThere is very little published work on dietary intake and nutritional status of Mozambicans. We conducted a population-based cross-sectional study on the diet and nutritional status of adolescent girls in different types of communities in Zambézia Province, Central Mozambique, in two distinct seasons.ObjectiveThe purpose of this paper is to present the design, methods, and study population characteristics of the Estudo do Estado Nutricional e da Dieta em Raparigas Adolescentes na Zambézia (the ZANE Study).MethodsData was collected in January-February 2010 ("hunger season") and in May-June 2010 ("harvest season"). A total of 551 girls in the age group 14-19 years old were recruited from one urban area and two districts (district towns and rural villages). The study protocol included a background interview, a 24-hour dietary recall interview, a food frequency questionnaire, anthropometric measurements, bioimpedance, hemoglobin measurement, and venous blood, urine, buccal cell, and fecal sampling.ResultsAdolescent motherhood was common in all study regions. Stunting prevalence for the total study population as a weighted percentage was 17.8% (95/549; 95% CI 14.3-22.0) with no regional differences. Overweight was found mainly in the urban area where the prevalence was 12.6% (20/159; 95% CI 7.5-17.6), thinness was rare. There were regional differences in the prevalence of malaria parasitemia and intestinal helminth infestation, but not human immunodeficiency virus.ConclusionsThe fully analyzed data from the ZANE Study will yield results useful for setting priorities in nutrition policy and further research on the diet and nutritional status in Mozambique and other countries with similar nutritional problems.Trial RegistrationClinicalTrials.gov: NCT01944891; http://www.clinicaltrials.gov/ct2/show/NCT01944891 (Archived by WebCite at http://www.webcitation.org/6L9OUrsq8).

Poor micronutrient intake and status is a public health problem among adolescent Mozambican girls

“…A previous article describes in detail the sampling design and field work methods, presents a flow chart showing the sample selection, and discusses challenges experienced during the sampling process [13]. In short, the participants were recruited in 2010 during 2 seasons: in January to February, the "hunger season," and in May to June, the harvest season.…”

“…A written consent was obtained from all the participants and, in addition, a parental consent was obtained for minors. If the girl or the parent (or husband or guardian) was illiterate, fingerprints were used or the informed consent form was signed by a witness [13]. The study was registered at ClinicalTrials.gov (NCT01944891).…”

“…Pregnancy, HIV, malaria, and intestinal helminth tests were performed. The processed plasma, serum, and urine samples were frozen at −15°C to −20°C and transported to Finland, where they were stored at −70°C [13]. Analyses of serum high-sensitivity C-reactive protein (hs-CRP), serum ferritin, serum selenium, plasma retinol, serum folate, and urinary iodine were carried out at the National Institute for Health and Welfare, Finland.…”

“…Weight was measured using a digital scale (Beurer glass bathroom scale GS 34, Beurer GmbH, Ulm, Germany) and recorded to the nearest 100 g. Background interviews were conducted, as described previously [13]. Literacy was tested by asking each participant to read a short test sentence out loud in Portuguese.…”

“…These were then used during the entry of the 24-hour dietary recall data. The details of recipe collection have been presented elsewhere [13]. When necessary, the main ingredients of the recipe were modified, as reported by the study participants.…”