Folic acid fortification of staple foods has been in place in many countries for over two decades. Studies have shown that folic acid fortification can significantly reduce incidence of neural tube defects. Tanzania adopted a mandatory fortification policy for commercially-produced wheat and maize flour in 2011. We determined factors influencing intake of folic acid-fortified flour among women of reproductive age (WRA). We conducted a cross-sectional study among WRA during March–April 2017 in Ifakara Town Council, Morogoro region. Multistage cluster sampling was used to select study participants. We used a questionnaire to capture information on demographics, awareness of folic acid, awareness of existence of folic acid fortified flour in community and intake of folic acid fortified flour. Intake was defined as reported consumption of folic acid fortified flour products at least once within 7 days before interview. Univariate, bivariate, and multivariable logistic analyses were done to evaluate factors associated with intake of folic acid fortified flour. The median age of the 698 participating WRA was 30 years (range: 18–49). Awareness of folic acid and folic acid fortified flour was 6.9% (95% CI: 5.2–9.0%) and 7.5% (95% CI: 5.7–9.6%), respectively. Consumption of folic acid fortified flour was 63.3% (95% CI: 59.7–66.8%). Independent factors associated with intake included being employed (aOR = 1.91; 95% CI: 1.19–3.06), having no children (nulliparity) (aOR = 2.59; 95% CI: 1.36–4.95) or having 1–4 children (aOR = 1.98; 95% CI: 1.17–3.33) (vs. 5 or more children), and folic acid awareness (aOR = 2.53; 95% CI: 1.30–4.92). Folic acid fortified flour was used by most respondents in our study despite low awareness of existence of folic acid fortified flour in the community. Being employed, having fewer than five children, and folic acid awareness were independent factors associated with intake. We recommend scaling up of mandatory flour fortification program and doing further studies on blood folate level among women of reproductive age in Ifakara to assess fortification program effectiveness.

中文翻译：

---

坦桑尼亚莫罗戈罗地区伊法卡拉市育龄妇女报告的叶酸强化面粉摄入量的相关意识和因素：一项横断面研究

二十多年来，许多国家已经在主食中实施叶酸强化。研究表明，叶酸强化可以显着降低神经管缺陷的发生率。坦桑尼亚于 2011 年对商业生产的小麦和玉米面粉采取了强制强化政策。我们确定了影响育龄妇女 (WRA) 摄入叶酸强化面粉的因素。我们于 2017 年 3 月至 4 月在莫罗戈罗地区的伊法卡拉市议会对 WRA 进行了横断面研究。多阶段整群抽样用于选择研究参与者。我们使用问卷来获取人口统计信息、叶酸意识、社区中存在叶酸强化面粉的意识以及叶酸强化面粉的摄入量。摄入量被定义为在采访前 7 天内报告的至少一次叶酸强化面粉产品的消费。进行单变量、双变量和多变量逻辑分析以评估与叶酸强化面粉摄入量相关的因素。698 名参与 WRA 的中位年龄为 30 岁（范围：18-49）。叶酸和叶酸强化面粉的认知度分别为 6.9%（95% CI：5.2-9.0%）和 7.5%（95% CI：5.7-9.6%）。叶酸强化面粉的消费量为 63.3%（95% CI：59.7–66.8%）。与摄入量相关的独立因素包括受雇（aOR = 1.91；95% CI：1.19-3.06）、没有孩子（未生育）（aOR = 2.59；95% CI：1.36-4.95）或有 1-4 个孩子（aOR = 1.98；95% CI：1.17–3.33）（与 5 名或更多儿童相比）和叶酸意识（aOR = 2.53；95% CI：1.30–4.92）。尽管社区中对叶酸强化面粉的认识不高，但在我们的研究中，大多数受访者都使用了叶酸强化面粉。受雇、少于五个孩子和叶酸意识是与摄入量相关的独立因素。我们建议扩大强制性面粉强化计划，并进一步研究伊法卡拉育龄妇女的血液叶酸水平，以评估强化计划的有效性。