Control of Vitamin A deficiency disorders through fortification of cassava flour with red palm oil: A case study of Kigoma district, Tanzania

Vitamin A deficiency (VAD) is one of the public health problems in Tanzania particularly among preschool children. Several approaches have been suggested for the control VAD in developing countries among which, fortification of locally produced staples with vitamin A or provitamin A was noted to be viable and sustainable. This study was conducted in Kigoma district of Tanzania as part of the efforts to fortify the locally produced cassava flour with an underutilized provitamin A rich food-red palm oil. Fortification was incorporated as part of the traditional processing practice for cassava flour. Results of a feeding program with the enriched cassava flour involving 162 preschool children indicated a significant (p<0.05) decrease in the prevalence of VAD (plasma retinol level >20μg/dL). Prevalence of VAD among preschool children in the pilot villages decreased from 53.0% (range 23.1-72.7%; plasma retinol levels 17.9-21.7 μg/dL) to 8.5% (range 5.5-9.8%; plasma retinol levels 21.4-21.9 μg/dL) at the end of the program. The children also gained more weight (range 5.9-6.5 kg) compared to their counterparts in the control group (range 3.8-4.2 kg). The pregnant and lactating women who participated in the program recorded a 12.6% (range 11.9-14.0%) increase in their plasma retinol concentrations compared to an increase of 3.5% (range 3.2-3.7%) in the control group. Average plasma retinol concentrations were significantly (p<0.05) higher among women in the pilot villages (mean 22.3 μg/dL; range 19.0-24.5 μg/dL) compared to their counterparts in the control villages (mean 20.3 μg/dL; range 19.8-20.8 μg/dL). Results of sensory and acceptability evaluation of the meals prepared from the fortified cassava flour showed that the product was highly liked and accepted despite several limitations. Based on this study, fortification of cassava flour with red palm oil has a potential for controlling VAD. In areas of the country where the red palm oil is produced in abundance, enriching cassava flour or other locally produced staples with red palm oil may thus provide a cheap and sustainable method for eliminating VAD. Fortification also improves the flavor hence acceptability of the oil, increases its utilization and improves the energy density of gruels and/or meals prepared from the enriched flour. It is suggested that a detailed study should be undertaken to determine the stability and keeping quality of the red palm oil enriched cassava flour under various conditions to enable a wider distribution of the product in the country.