{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:56:31Z","timestamp":1777640191688,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2010,6,1]],"date-time":"2010-06-01T00:00:00Z","timestamp":1275350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Twenty-eight percent of Ugandan preschool children suffer from vitamin A deficiency. With vitamin A supplementation covering only a third of children under 5 years of age, fortification is essential to reduce their vitamin A deficiency\u2013related disease burden. At present, the only widely consumed food in Uganda that is fortified with vitamin A is vegetable oil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the feasibility, coverage, costs, and cost-effectiveness of fortifying vegetable oil and sugar with vitamin A in order to assess, from a public health policy perspective, whether sugar should also be fortified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2005\/6 Uganda Household Budget Survey was used to analyze households' apparent consumption levels of sugar and vegetable oil and to model the additional intake of vitamin A, assuming the sugar and oil fortification levels are those set by the Uganda Bureau of Standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The annual incremental private sector cost of vitamin fortification is US$555,668 for oil and US$2,644,765 for sugar. Assuming that oil and sugar fortification are both effective in reducing vitamin A deficiency by 30% among those who consume these foods, the estimated cost per disability-adjusted life year (DALY) averted is US$82 for sugar and US$18 for oil. Vitamin A fortification of vegetable oil is 4.6 times more cost-effective than vitamin A fortification of sugar. If sugar were to be fortified, the 17% of Ugandans who purchase sugar but do not purchase oil would become new beneficiaries of vitamin A fortification. This would increase the coverage of vitamin A\u2013fortified foods by 31% and reduce the percentage of Ugandans without any coverage to 25%. Those most at risk for vitamin A deficiency\u2014members of rural, poor households\u2014would benefit disproportionately from the introduction of sugar fortification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the lack of information on the vitamin A deficiency status of consumers of oil and sugar precludes making definitive conclusions, the increased coverage and cost per DALY averted due to sugar fortification suggests\u2014based on World Health Organization guidelines\u2014that the Government of Uganda should pursue sugar fortification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/156482651003100202","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T16:01:32Z","timestamp":1448467292000},"page":"193-205","source":"Crossref","is-referenced-by-count":51,"title":["Vitamin A Fortification in Uganda: Comparing the Feasibility, Coverage, Costs, and Cost-Effectiveness of Fortifying Vegetable Oil and Sugar"],"prefix":"10.1177","volume":"31","author":[{"given":"John L.","family":"Fiedler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Afidra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2010,6,1]]},"reference":[{"key":"bibr1-156482651003100202","first-page":"551","volume-title":"Disease control priorities in developing countries","author":"Caufield LE","year":"2006","edition":"2"},{"key":"bibr2-156482651003100202","volume-title":"Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes","author":"World Health Organization","year":"1996"},{"key":"bibr3-156482651003100202","first-page":"227","volume":"79","author":"Gilbert C","year":"2001","journal-title":"Bull World Health Organ"},{"key":"bibr4-156482651003100202","first-page":"214","volume":"79","author":"Whitcher JP","year":"2001","journal-title":"Bull World Health Organ"},{"key":"bibr5-156482651003100202","volume-title":"Analyzing the health benefits of biofortified staple crops by means of the disability-adjusted life years approach: a handbook focusing on iron, zinc and vitamin A","author":"Stein A","year":"2005"},{"key":"bibr6-156482651003100202","volume-title":"Uganda Demographic and Health Survey 2000\u20132001","year":"2001"},{"key":"bibr7-156482651003100202","volume-title":"Uganda Demographic and Health Survey 2005\/06","year":"2007"},{"key":"bibr8-156482651003100202","volume-title":"April 2007 round","author":"National Child Days Plus (CDP) vitamin A &amp; de-worming coverage results","year":"2007"},{"key":"bibr9-156482651003100202","volume-title":"November 2007 round","author":"National Child Days Plus (CDP) vitamin A &amp; de-worming coverage results","year":"2007"},{"key":"bibr10-156482651003100202","unstructured":"Manual for internal monitoring of oil fortified with vitamin A (quality assurance and quality control, AQ\/QC). Arusha, Tanzania: East, Central and Southern African (ECSA) Health Community, 2007. Available at: http:\/\/www.a2zproject.org\/pdf\/Manual%20for%20Internal%20Monitoring%20of%20Oil%20Fortified%20with%20Vitamin%20A.pdf. Accessed 19 April 2010."},{"key":"bibr11-156482651003100202","unstructured":"Uganda Bureau of Statistics. Uganda National Household Survey (UNHS) 2005\/06. An overview of UNHS 2005\/06. Kampala, 2006. Available at: http:\/\/www.ubos.org\/nada\/ddibrowser\/?id=5. Accessed 2 May 2010."},{"key":"bibr12-156482651003100202","volume-title":"Tenth annual report for calendar year 2007","author":"Uganda Sugar Cane Technologists' Association (USCTA)","year":"2008"},{"key":"bibr13-156482651003100202","volume-title":"The food fortification formulator: Technical determination of fortification levels and standards for mass fortification","author":"Dary O","year":"2008"},{"key":"bibr14-156482651003100202","volume-title":"Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc","author":"Food and Nutrition Board, Institute of Medicine, US National Academy of Sciences","year":"2001"},{"key":"bibr15-156482651003100202","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/134.10.2678"},{"key":"bibr16-156482651003100202","unstructured":"World Bank. Uganda\u2014country brief 2009. Available at: http:\/\/web.worldbank.org\/WBSITE\/EXTERNAL\/COUNTRIES\/AFRICAEXT\/UGANDAEXTN\/0,menuPK:374947\u223cpagePK:141132\u223cpiPK:141107\u223ctheSitePK:374864,00.html. Accessed 20 April 2010."},{"key":"bibr17-156482651003100202","volume-title":"Making choices in health: WHO guide to cost-effectiveness analysis","author":"Tan-Torres TE","year":"2003"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482651003100202","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/156482651003100202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:16:04Z","timestamp":1777443364000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/156482651003100202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,6]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,6]]}},"alternative-id":["10.1177\/156482651003100202"],"URL":"https:\/\/doi.org\/10.1177\/156482651003100202","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6]]}}}