Field-friendly techniques for assessment of biomarkers of nutrition for development

Abstract

Whereas cost-effective interventions exist for the control of micronutrient malnutrition (MN), in low-resource settings field-friendly tools to assess the effect of these interventions are underutilized or not readily availablewhere they are most needed. Conventional approaches for MN measurement are expensive and require relatively sophisticated laboratory instrumentation, skilled technicians, good infrastructure, and reliable sources of clean water and electricity. Consequently, there is a need to develop and introduce innovative tools that are appropriate forMNassessment in low-resource settings. These diagnostics should be cost-effective, simple to perform, robust, accurate, and capable of being performedwith basic laboratory equipment. Currently, such technologies either do not exist or have been applied to the assessment of a few micronutrients. In the Demographic and Health Surveys (DHS), a fewsuch examples for which "biomarkers" of nutrition development have been assessed in low-resource settings using field-friendly approaches are hemoglobin (anemia), retinol-binding protein (vitamin A),andiron(transferrinreceptor). Inall oftheseexamples,sampleswere collectedmainlybynonmedical staffandanalyseswereconductedinthe survey countrybytechnicians fromthe localhealthor researchfacilities. This article provides information on howtheDHS has been able to successfully adaptfield-friendly techniques in challenging environments in population-based surveys for the assessment of micronutrient deficiencies. Special emphasis is placed on sample collection, processing, and testing in relation to the availability of local technology, resources, and capacity. © 2011 American Society for Nutrition.