Background: Australia implemented mandatory folic acid fortification of bread-making flour in 2009. Objective: To assess the impact of folic acid fortification in remote vs. regional urban areas and Indigenous vs. non-Indigenous populations in northern Queensland. Methods: Routinely collected data on folic acid measurements in remote areas and two regional urban centres in northern Queensland between 2004 and 2015 were analysed (n = 13,929) dichotomously (folic deficient vs. non-deficient). Results: Overall prevalence of folic acid deficiency was 3.2% (235/7282) in urban centres compared with 7.2% (480/6647) in remote areas (p < 0.001), and 9.3% (393/4240) in the Indigenous population compared with 3.2% (273/8451) in the non-Indigenous population (p < 0.001). Prevalence of folic acid deficiency dropped from 12.2% (n = 481) in 2004-2008 to 1.5% (n = 126) in 2010-2015 (p < 0.001). This translates into a relative risk reduction (RRR) of 88%. RRR was 79% (7.2% vs. 1.5%) in urban centres, 91% (17.3% vs. 1.5%) in remote areas, 92% (20.5% vs. 1.6%) in the Indigenous population and 80% (7.4% vs. 1.5%) in the non-Indigenous population (p < 0.001 for all). Conclusions: Substantial declines of folic acid deficiency to low and comparable proportions in former high-risk populations indicate that mandatory folic acid fortification of flour has had a population-wide benefit in northern Queensland.

中文翻译：

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在澳大利亚昆士兰州北部偏远地区实施强制性叶酸强化后，叶酸缺乏比例低：二次健康数据分析。

背景：澳大利亚于2009年对面包粉进行了强制性叶酸强化。目的：评估叶酸强化对昆士兰州北部偏远地区，市区城市以及土著居民与非土著居民的影响。方法：按照二分法（n = 13,929）（叶缺乏与不缺乏）对昆士兰州北部偏远地区和两个区域城市中心的常规叶酸测量数据进行了分析（n = 13,929）。结果：城市中心地区的叶酸缺乏症总体患病率为3.2％（235/7282），而偏远地区为7.2％（480/6647）（p <0.001），而土著居民为9.3％（393/4240）在非土著人口中占3.2％（273/8451）（p <0.001）。叶酸缺乏症的患病率从2004-2008年的12.2％（n = 481）下降到1。2010-2015年为5％（n = 126）（p <0.001）。这意味着相对风险降低（RRR）为88％。城市中心的存款准备金率分别为79％（7.2％vs. 1.5％），偏远地区的91％（17.3％vs. 1.5％），土著居民的92％（20.5％vs. 1.6％）和80％（7.4％）而非非土著人口中的1.5％）（所有人群的p <0.001）。结论：在以前的高风险人群中，叶酸缺乏症的比例大幅下降至较低的比例，这表明昆士兰州北部的强制性叶酸强化面粉在全民受益。0.001）。结论：在以前的高风险人群中，叶酸缺乏症的比例大幅下降至较低的比例，这表明昆士兰州北部的强制性叶酸强化面粉在全民受益。0.001）。结论：在以前的高风险人群中，叶酸缺乏症的比例大幅下降至低比例，这表明昆士兰州北部的强制性叶酸强化面粉在全民受益。