Date of Award

Spring 5-11-2013

Degree Type


Degree Name

Master of Science (MS)



First Advisor

Dr Vijay Ganji


Purpose: Anemia in children is a major Public Health problem in developing countries such as Ivory Coast. The fortification of wheat flour with iron and folic acid has been mandated in this country in 2007. To date, there are no studies conducted to assess the effectiveness of these fortification efforts. Therefore, the purpose of this study was to determine if mandated iron and folic acid fortification of wheat flour has reduced the prevalence of anemia in Ivory Coast children.

Methods: The study was conducted at the pediatric unit of the university hospital of Treichville, one of the 3 main hospitals of Abidjan, the largest city of Ivory Coast. The medical records of 467 children from 5 to 14 years old were analyzed. The period from January 1st 2004 to December 31st 2006 was considered as pre-fortification period and the period from January 1st 2008 to December 31st 2010 was regarded as the post-fortification period. Data for anemia, hemoglobin, hematocrit, red blood cell count, and MCV were compared between pre- and post-fortification periods.

Results: The results showed that there were no statistically significant difference in prevalence of anemia and mean hemoglobin, hematocrit, red blood cells, and MCV between pre and post-fortification periods.

Conclusion: The double fortification of wheat flour with folic acid and iron had no significant impact on anemia in Ivorian children. This is perhaps due to the fact that wheat flour is not widely consumed as rice and rice products are more popular in Ivory Coast population. The Ivorian government perhaps should focus efforts on the fortification of these products.