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A pilot survey of selenium status and its geospatial variation among children and women in three rural districts of Zimbabwe

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Beaula Mutonhodza, Christopher Chagumaira, Mavis Precious Dembedza, Edward J. M. Joy, Muneta G. Manzeke‐Kangara, Handrea Njovo, Tasiana K. Nyadzayo, R. M. Lark, Alexander Kalimbira, Elizabeth H. Bailey, Martin R. Broadley, Tonderayi M. Matsungo, Prosper Chopera

A hidden shortage of a tiny mineral may affect nearly every young child tested in three rural districts of Zimbabwe. And the risk is not spread evenly: where a family lives appears to matter.

Abstract

Introduction: Selenium (Se) deficiency is increasingly recognized as a public health problem in sub-Saharan Africa. Methods: The current cross-sectional study assessed the prevalence and geospatial patterns of Se deficiency among children aged 6–59 months (n = 741) and women of 15–49 years old (n = 831) selected by simple random sampling in rural Zimbabwe (Murewa, Shamva, and Mutasa districts). Venous blood samples were collected and stored according to World Health Organization guidelines. Plasma Se concentration was determined by inductively coupled plasma-mass spectrometry. Results: Median, Q1, and Q3 plasma Se concentrations were 61.2, 48.7, and 73.3 μg/L for women and 40.5, 31.3, and 49.5 μg/L for children, respectively. Low plasma Se concentrations (9.41 μg/L in children and 10.20 μg/L in women) indicative of severe Se deficiency risk was observed. Overall, 94.6% of children and 69.8% of women had sub-optimal Se status defined by plasma Se concentrations of <64.8 μg/L and <70 μg/L, respectively. Discussion: High and widespread Se deficiency among women and children in the three districts is of public health concern and might be prevalent in other rural districts in Zimbabwe. Geostatistical analysis by conditional kriging showed a high risk of Se deficiency and that the Se status in women and children in Murewa, Shamva, and Mutasa districts was driven by short-range variations of up to ∼12 km. Selenium status was homogenous within each district. However, there was substantial inter-district variation, indicative of marked spatial patterns if the sampling area is scaled up. A nationwide survey that explores the extent and spatial distribution of Se deficiency is warranted.

Transcript

A hidden shortage of a tiny mineral may affect nearly every young child tested in three rural districts of Zimbabwe. And the risk is not spread evenly: where a family lives appears to matter. Worldwide, an estimated one-in-two children aged six to fifty-nine months and two-in-three women of reproductive age have at least one vitamin or mineral deficiency.

In sub-Saharan Africa, these groups are especially vulnerable. Recent estimates of dietary mineral supplies indicate that deficiencies such as selenium may have considerable public health significance. Selenium is a mineral the body needs, so a shortage can affect whole communities, not just isolated patients.

That makes the question practical: in rural Zimbabwe, how common is low selenium, and does the answer change from one place to another? The survey examined selenium deficiency among young children and women of reproductive age in three rural districts of Zimbabwe: Murewa, Shamva, and Mutasa.

These districts were chosen because they had high levels of stunted growth and low dietary diversity, with relatively few young children receiving the minimum range of food groups. To understand the geography, the survey examined selenium deficiency and its geospatial patterns among women of reproductive age and young children across three rural districts in Zimbabwe.

The survey compared blood selenium levels with thresholds linked to the body’s ability to carry out important selenium-dependent functions. The analysis used ordinary kriging to predict selenium levels for unsampled women and young children at the household level across three districts.

Those predictions were checked by leaving out each observed measurement in turn and seeing how well the model could predict it. The results were striking. The middle selenium level was lower in children than in women, and some children and women had levels indicating a risk of severe deficiency.

Overall, ninety-four point six percent of children and sixty-nine point eight percent of women had selenium levels below the study’s chosen ranges for adequate status. The geographic estimates suggested that low selenium was not confined to the households that had been tested.

In Murewa and Shamva, the estimated chance that an untested child was below the chosen threshold was about ninety-eight percent. For women, the estimated chance of falling below the threshold was also about ninety-eight percent in Shamva, while it was lower, at about seventy-three percent, in Mutasa.

Among the unsampled children aged six to fifty-nine months, those residing in Murewa had the highest likelihood of being selenium deficient. In these rural areas, low selenium is not an isolated problem: nearly all unsampled children and women were judged likely to have levels below those needed for important protective body functions, pointing to a widespread nutritional risk.

The women’s middle selenium levels were similar to levels reported in other African countries. But the children’s middle levels were low even compared with a country known to have selenium deficiency. Average levels around the world are higher, showing the scale of the deficiency risk in the Zimbabwean population studied here.

There is an important limit: the survey covered a limited geographic area, so it cannot establish the selenium situation across all of Zimbabwe. There is also no agreed single threshold for selenium deficiency risk, and the survey measured blood selenium as an indirect sign of how the body’s selenium-dependent proteins were functioning.

Because the study was limited geographically, it could not establish selenium status or deficiency risk across Zimbabwe, leaving the nationwide scale unresolved. Additional direct measurements of selenoproteins would complement these findings, because plasma selenium may not fully reflect the body’s selenoprotein status.

The study found widespread selenium deficiency among children and women in all three pilot districts. Within each district, there was no marked pattern, but the districts differed substantially from one another. The differences were driven by short-range variation, so local conditions could change over relatively small distances, even though there was no marked spatial pattern within the districts.

For families, the message is not that every household faces exactly the same risk. It is that broader testing could reveal where support is most needed, helping public-health efforts respond to real local conditions. The survey found widespread low selenium status among children and women in all three districts, with important differences between districts.

That points to a need for wider testing before solutions can be targeted safely.

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