What do we know about micronutrient supplementation in pregnancy in relationship to infection e'g',

1
What do we know about micronutrient
supplementation in pregnancy? (in relationship
to infection -- e.g., malaria)

• Richard W. Steketee,
• Division of Parasitic Diseases
• U.S. Centers for Disease Control and Prevention

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Impaired immunity
Cycle Nutrition, Infection and their Consequences
Higher mortality rate
Impaired mental development
Increased risk of adult chronic disease
Baby Low Birth Weight
Reduced capacity to care for baby
Elderly Malnourished
Untimely / inadequate weaning
Frequent infections
Inadequate catch up growth
Inadequate fetal nutrition
Inadequate food, health care
Inadequate food, health care
Infection e.g. malaria
Anemia
Anemia
Child Stunted
Reduced mental capacity
Adolescent Stunted
Inadequate food, health care
Higher maternal mortality
Inadequate food, health care
Reduced mental capacity
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Impaired immunity
Cycle Nutrition, Infection and their Consequences
Higher mortality rate
Impaired mental development
Increased risk of adult chronic disease
Baby Low Birth Weight
Reduced capacity to care for baby
Elderly Malnourished
Untimely / inadequate weaning
Frequent infections
Inadequate catch up growth
Inadequate fetal nutrition
Inadequate food, health care
Inadequate food, health care
Infection e.g. malaria
Anemia
Anemia
Child Stunted
Reduced mental capacity
Adolescent Stunted
Inadequate food, health care
Higher maternal mortality
Inadequate food, health care
Reduced mental capacity
4
Impaired immunity
Cycle Nutrition, Infection and their Consequences
Higher mortality rate
Impaired mental development
Increased risk of adult chronic disease
Baby Low Birth Weight
Reduced capacity to care for baby
Elderly Malnourished
Untimely / inadequate weaning
Frequent infections
Inadequate catch up growth
Inadequate fetal nutrition
Inadequate food, health care
Inadequate food, health care
Infection e.g. malaria
Anemia
Anemia
Child Stunted
Reduced mental capacity
Adolescent Stunted
Inadequate food, health care
Higher maternal mortality
Inadequate food, health care
Reduced mental capacity
5
Impaired immunity
Cycle Nutrition, Infection and their Consequences
Higher mortality rate
Impaired mental development
Increased risk of adult chronic disease
Baby Low Birth Weight
Reduced capacity to care for baby
Elderly Malnourished
Untimely / inadequate weaning
Frequent infections
Inadequate catch up growth
Inadequate fetal nutrition
Inadequate food, health care
Inadequate food, health care
Infection e.g. malaria
Anemia
Anemia
Child Stunted
Reduced mental capacity
Adolescent Stunted
Inadequate food, health care
Higher maternal mortality
Inadequate food, health care
Reduced mental capacity
6
Impaired immunity
Cycle Nutrition, Infection and their Consequences
Higher mortality rate
Impaired mental development
Increased risk of adult chronic disease
Baby Low Birth Weight
Reduced capacity to care for baby
Elderly Malnourished
Untimely / inadequate weaning
Frequent infections
Inadequate catch up growth
Inadequate fetal nutrition
Inadequate food, health care
Inadequate food, health care
Infection e.g. malaria
Anemia
Anemia
Child Stunted
Reduced mental capacity
Adolescent Stunted
Inadequate food, health care
Higher maternal mortality
Inadequate food, health care
Reduced mental capacity
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Pregnancy, Nutrition and Infection

• Micronutrient needs in pregnancy
• Iron
• Folate
• Vit A
• Zinc
• Other?

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Pregnancy, Nutrition and Infection

• Infection
• Malaria Intestinal helminths other common
  infections
• Decreased nutrient intake
• Increased nutrient use
• Infection-specific insult

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Micronutrient deficiency, and supplementation
opportunity
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Micronutrient needs and Intervention opportunities

• Combined antiparasitic nutritional/micronutrient
  strategies
• e.g., malaria, hookworm anemia -- antimalarial
  drugs, antihelminth drugs, iron, folate
• Prevention and treatment prior to pregnancy
• Health service delivery systems
• Antenatal care
• Reaching adolescents
• Using non-medical approaches

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Antenatal care in AfricaProportion of Pregnant
Women Seeking Antenatal Clinic Care
Demographic and Health Surveys