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Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children
Thesis (MNutr)--Stellenbosch University, 2023.
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| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2023
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| _version_ | 1867614014447550464 |
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| access_status_str | Open Access |
| author | Palframan, Karla |
| author2 | Blaauw, Renee |
| author_browse | Blaauw, Renee Palframan, Karla |
| author_facet | Blaauw, Renee Palframan, Karla |
| author_sort | Palframan, Karla |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MNutr)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/128418 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:45:17.761Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/128418 Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children Palframan, Karla Blaauw, Renee Baumgartner, Jeannine Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Division of Human Nutrition. Iron deficiency anemia in children -- South Africa Malnutrition in children -- South Africa Children -- Health and hygiene -- South Africa Nutrition -- Evaluation -- South Africa UCTD Thesis (MNutr)--Stellenbosch University, 2023. ENGLISH SUMMARY: Context: Children are at a higher risk of anaemia due to their increased iron requirements during periods of rapid growth. This risk is even higher in children in sub-Saharan Africa due to the poor iron bioavailability in their staple foods. Anaemia remains a common co-morbidity of HIV and increases the progression to AIDS and risk of mortality. Due to inflammation and iron deficiency amongst children living with HIV, the impact of iron interventions such as food fortification or iron supplementation, is unclear. Determining iron bioavailability within this population will allow for physiologic requirements to be converted into dietary recommendations thus supporting more targeted public health policies. Unfortunately, no suitable methods for determining iron bioavailability in children at the population level exist. Predictive algorithms have been developed to provide a simpler, more cost-effective method for determining iron bioavailability, however current predictive algorithms have not been assessed in children. Validating these algorithms will provide practical cost-effective tools for healthcare workers to use when assessing iron absorption in children and allow for the development of public health policies that help reduce iron deficiency-anaemia in the population. Objectives: The primary objective of this study was to determine whether existing predictive algorithms accurately determine dietary iron bioavailability in HIV+ and HIV-ve South African children. Secondly, this study aimed to determine whether there was a difference in the accuracy of these predictive algorithms in determining iron bioavailability in HIV+ compared to HIV-ve children, females compared to males, iron deficient compared to iron sufficient children and children with and without the presence of inflammation. Method: A list of existing predictive algorithms was identified in the literature and the suitability of each algorithm for this data set was assessed. The two algorithms chosen for this study, Armah et al and Collings et al, were built into an excel spreadsheet. All variables required to calculate these algorithms, such as dietary data and physiological values were extracted from the database of the parent study. The iron absorption values calculated from each algorithm were then compared to actual iron absorption measured using stable iron isotopes. Statistical analysis was then performed using SPSS version 27 (IBM Corp., New York, USA). Results: Our findings indicate good agreement between iron absorption measured using stable iron isotopes and iron absorption calculated using the algorithm developed by Armah et al, as the median iron absorption between these values was not statically different (p=0.44). This algorithm showed good agreement in all children (aged 8-13 years) regardless of their sex, HIV status, iron status or inflammatory status. The algorithm developed by Collings et al underestimated iron absorption, and these differences were statistically significant (p<0.001). Conclusion: The algorithm developed by Armah et al was identified as a suitable, cost-effective alternative to stable iron isotopes when predicting iron bioavailability in the diet. We recommend this algorithm is used as a feasible alternative to stable iron isotopes in resource limited areas as it only requires dietary data and serum ferritin to predict iron bioavailability in the diet. AFRIKAANSE OPSOMMING: Konteks: Kinders het ‘n hoer risiko vir anemie as gevolg van hul verhoogde ysterbehoeftes gedurende periodes van vinnige groei. Hierdie risiko is selfs hoer by kinders in Sub-Sahara Afrika as gevolg van die swak ysterbiobeskikbaarheid in hul stapelvoedsel. Anemie bly 'n algemene komorbiditeit van MIV en verhoog die vordering tot vigs en risiko van sterftes. As gevolg van inflammasie en ystertekort onder kinders wat met MIV leef, is die impak van ysterintervensies soos voedselfortifisering of ysteraanvulling onduidelik. Die bepaling van ysterbiobeskikbaarheid binne hierdie populasie sal toelaat dat fisiologiese vereistes omgeskakel word in dieetaanbevelings en sodoende meer geteikende openbare gesondheidsbeleide ondersteun. Ongelukkig bestaan daar geen geskikte metodes om ysterbiobeskikbaarheid by kinders te bepaal nie. Voorspellende algoritmes is ontwikkel om 'n eenvoudiger, meer koste-effektiewe metode te verskaf vir die bepaling van ysterbiobeskikbaarheid, maar huidige voorspellende algoritmes is nog nie by kinders geassesseer nie. Die validering van hierdie algoritmes sal praktiese koste-effektiewe hulpmiddels vir gesondheidsorgwerkers verskaf om te gebruik wanneer ysterabsorpsie by kinders geassesseer word. Dit sal voorsiening maak vir die ontwikkeling van openbare gesondheidsbeleide wat help om ystertekort-anemie te verminder in die bevolking. Doelwitte: Die primere doel van hierdie studie was om vas te stel of bestaande voorspellende algoritmes die dieet-ysterbiobeskikbaarheid akkuraat bepaal in MIV+ en MIV- Suid-Afrikaanse kinders. Tweedens was hierdie studie daarop gemik om vas te stel of daar 'n verskil was in die akkuraatheid van hierdie voorspellende algoritmes in die bepaling van ysterbiobeskikbaarheid in MIV+ versus MIV- kinders, dogters versus seuns, ystertekort versus yster voldoende kinders en kinders met en sonder die teenwoordigheid van inflammasie. Metode: 'n Lys van bestaande voorspellende algoritmes is in die literatuur geidentifiseer en die geskiktheid van elke algoritme vir hierdie datastel is beoordeel. Die twee verkose algoritmes, Armah et al en Collings et al, is in 'n Excel-sigblad ingebou. Alle veranderlikes wat nodig is om hierdie algoritmes te bereken, soos dieetdata en fisiologiese waardes, is uit die databasis van die hoofstudie onttrek. Die ysterabsorpsiewaardes wat uit elke algoritme bereken is, is dan vergelyk met werklike ysterabsorpsie gemeet met behulp van stabiele ysterisotope. Statistiese analise is daarna uitgevoer met behulp van SPSS weergawe 27 (IBM Corp., New York, VSA). Resultate: Ons bevindinge dui op goeie ooreenkoms tussen ysterabsorpsie gemeet deur stabiele ysterisotope en ysterabsorpsie bereken deur die algoritme wat deur Armah et al ontwikkel is, aangesien die mediaan ysterabsorpsie tussen hierdie waardes nie statisties betekenisvol verskil het nie (p=0.44). Hierdie algoritme het goeie ooreenstemming in alle kinders (8-13 jaar oud) getoon, ongeag hul geslag, MIV-status, ysterstatus of inflammatoriese status. Die algoritme wat deur Collings et al ontwikkel is, het ysterabsorpsie onderskat, en hierdie verskille was statisties betekenisvol (p<0.001). Afsluiting: Die algoritme wat deur Armah et al ontwikkel is, is geidentifiseer as 'n geskikte, koste-effektiewe alternatief vir stabiele ysterisotope wanneer ysterbiobeskikbaarheid in die dieet voorspel word. Ons beveel aan dat hierdie algoritme as 'n haalbare alternatief vir stabiele ysterisotope in gebiede met beperkte hulpbronne gebruik word, aangesien dit slegs dieetdata en serumferritien benodig om ysterbiobeskikbaarheid in die dieet te voorspel. Masters 2023-03-06T07:53:03Z 2023-08-30T13:12:37Z 2023-03 2023-03-06T07:53:03Z 2023-08-31T09:18:39Z 2023-03-06T07:53:03Z 2023-08-31T09:18:39Z 2023-03 Thesis https://scholar.sun.ac.za/handle/10019.1/128418 en_ZA Stellenbosch University application/pdf 74 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Iron deficiency anemia in children -- South Africa Malnutrition in children -- South Africa Children -- Health and hygiene -- South Africa Nutrition -- Evaluation -- South Africa UCTD Palframan, Karla Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title | Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title_full | Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title_fullStr | Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title_full_unstemmed | Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title_short | Determining the potential of available predictive algorithms in determining dietary iron bioavailability in South African children |
| title_sort | determining the potential of available predictive algorithms in determining dietary iron bioavailability in south african children |
| topic | Iron deficiency anemia in children -- South Africa Malnutrition in children -- South Africa Children -- Health and hygiene -- South Africa Nutrition -- Evaluation -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/128418 |
| work_keys_str_mv | AT palframankarla determiningthepotentialofavailablepredictivealgorithmsindeterminingdietaryironbioavailabilityinsouthafricanchildren |