Status of prevention of neural tube defects post-folic acid fortification of cereal grains in South Africa.

Autor: Kancherla V; Center for Spina Bifida Prevention, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Randall P; P Cubed, Pretoria, Gauteng, South Africa., Christianson AL; University of the Witwatersrand, Johannesburg, Gauteng, South Africa., Malherbe HL; Centre for Human Metabolomics, North-West University, Potchefstroom, North-West Province, South Africa.; Rare Diseases South Africa NPC, Sandton, Gauteng, South Africa.
Jazyk: angličtina
Zdroj: Public health nutrition [Public Health Nutr] 2024 Nov 29; Vol. 27 (1), pp. e258. Date of Electronic Publication: 2024 Nov 29.
DOI: 10.1017/S1368980024002271
Abstrakt: Objective: Neural tube defects (NTD) are serious, life-threatening birth defects. Staple food fortification with folic acid (vitamin B 9 ) is a proven, effective intervention to reduce NTD birth prevalence. Mandatory food fortification with folic acid was implemented in South Africa (SA) in 2003. This article provides an overview of NTD birth prevalence in SA, pre- and post-fortification, and evaluates current folic acid fortification regulations.
Design: Fortification effectiveness data in SA were reviewed using published studies and national reports on NTD birth prevalence pre- and post-folic acid fortification. Current folic acid fortification regulations in SA were evaluated by experts.
Setting: Regulations were assessed using national health guidelines, legislation and regulations. NTD birth prevalence data were sourced from the published literature.
Participants: None.
Results: Significant reductions in the birth prevalence of spina bifida and anencephaly and improved maternal folate levels have been achieved following the introduction of folic acid fortification in SA. However, there is poor overall regulatory compliance in some instances and a gap in current regulations that excludes the fortification of cake flour in SA.
Conclusions: While the SA NTD birth prevalence has decreased by 30% post-fortification, the regulatory exclusion of cake flour fortification is a significant and growing issue. Proposed 2016 regulatory amendments to address this gap urgently require finalisation and enactment by government to prevent negating benefits achieved to date and to ensure continued improvement. Fortification monitoring requires strengthening to ensure widespread compliance with policies, particularly in underserved areas.
Databáze: MEDLINE
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