Efficacy of multiple micronutrient supplementations on child health: study design and baseline characteristics (original) (raw)
Related papers
Five decades of trends in anemia in Israeli infants: implications for food fortification policy
European Journal of Clinical Nutrition, 2001
Objective: To describe the secular trends in the prevalence rates 0.. iron-deficiency anemia (IDA) in infants in Israel, identify population group differences and assess the effectiveness of the 1985 Public Health directives on iron supplementation and avoidance of cow's milk in the first year of life. Design: A systematic analysis of published and unpublished cross-sectional studies. Methods: IDA rates in l-y-old infants between 1946 and 1997 were assessed from published papers and reports. Rates for Arab infants were available from 1984. Data on routine hemoglobin tests on I-y-old infants for Arabs and Jews separately were obtained from four health districts for the period 1987 to 1997. Analyses were done for the periods prior to and following the Public Health directives. Results: The prevalence of IDA in Jewish infants declined from 68°/. in 1946 to 50% in 1985 at an average annual rate of -1.43%. Following the iron supplementation directives, the average annual rate of decline increased to -4.0% and reached a prevalence of about II % in 1996. IDA rates in Arab infants declined by an annual average of -3.7%, and were consistently almost twice as high as for Jewish infants. Conclusions: Despite the contribution of the iron supplementation program to the reduction in IDA, the persistently high rates indicate inadequate iron content in the diet This emphasizes the important role of a national food fortification program, using staple foods commonly consumed.
The Israel Medical Association journal: IMAJ
Iron deficiency is the most prevalent anemia in infants and is known to be a major public health problem. To examine mothers' knowledge and adherence with recommendations regarding iron supplementation and assess their association with the prevalence of anemia in infants. Data on 101 infants and mothers of infants born between November 2000 and February 2001 and living in a small Jewish town in southern Israel were collected using a structured questionnaire and the infants' medical charts. Anemia was defined as serum hemoglobin less than 11 g/dl. Independent variables include socioeconomic data, mothers' knowledge, and adherence to treatment as reported by them. Chi-square test was used to analyze categorical variables, t-test was used for continuous variables, and hemoglobin was tested at 9-12 months of age. Of the 101 infants in the study, 47% had serum hemoglobin under 11 g/dl. Of the mothers, 62 (62%) were partially or completely non-compliant with iron supplementati...
Nutrients
Cost-effective interventions are needed to address undernutrition, particularly micronutrient deficiencies, which are common in children under the age of five in low- and middle-income countries. A community-based, non-randomized clinical trial was undertaken in the Kurram district of Khyber Pakhtunkhwa from January 2018 to June 2019, to evaluate the effect of locally produced micronutrient powder (local name: Vita-Mixe) on plasma micronutrient status, hemoglobin level, and anthropometric outcomes. Children aged 24–48 months old were recruited and allocated to the intervention and control arm of the study. The enrolled children in the intervention arm received one micronutrient powder (MNP) sachet for consumption on alternate days for 12 months. To assess the impact of the intervention on plasma levels of zinc, vitamin D, vitamin A, and hemoglobin level, blood samples were taken at baseline and after one year following the intervention. The analysis was conducted using Enzyme-Linked...
Scientifica
In Tanzania’s Arusha District, anaemia is a significant public health problem. Recently, home fortification with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be effective. However, it is a challenge for deprived families with low income to afford the daily sachet. The aim of this study was to compare the efficacy of different administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. This research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n=369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either five sachets (n=60), three sachets (n=80), two sachets (n=105), or one sachet (n=124) for six months; 310 children completed the study. Using the HemoCue technique, a finger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin le...
Journal of Pediatric Gastroenterology & Nutrition, 2006
Objectives: To assess and compare efficacy of two micronutrient sprinkle supplementation on growth, anemia, and iron deficiency in Cambodian infants. Methods: A total of 204 infants aged 6 months and living in Kompong Chhnang Province, Cambodia were randomly assigned to receive daily supplements of either iron (12.5 mg) plus folic acid (150 Kg) plus zinc (5 mg) (MMN, n = 68), or iron (12.5 mg) plus folic acid (150 Kg) alone (FFA, n = 68), or placebo (n = 68) for a 12 month period in powder form as sprinkles. Anthropometrics was evaluated bimonthly. Biochemical assessment was performed at baseline and at the end of intervention period. Results: At baseline, the overall mean (SD) of hemoglobin concentration was 101 g/L. No difference among groups was found for growth pattern. Significant decline was observed for weight-forage and height-forage z-scores in any group (P G 0.0001). The rate of recovery from anemia was significant (P G 0.001) and comparable between MMN (54%) and FFA (53%) groups and higher than in the placebo group (22%, P G 0.0001). Through the study period, no significant change in the rate of iron deficiency was found in MMN and FFA groups, whereas it increased in the placebo group (31%, baseline vs. 52%, end of study; P G 0.0001). Conclusion: Both MMN and FFA supplements were effective for preventing or treating anemia in Cambodian infants and stabilizing plasma levels of ferritin. Use of micronutrients in a controlled home setting, as sprinkled daily supplements, may be promising in preventing and treating anemia in developing countries. JPGN 42:306Y312, 2006.
The Journal of Nutrition, 2005
Multiple micronutrient deficiencies are highly prevalent in Indonesia, but the interventions are still focused on single micronutrients. This study aimed to investigate the efficacy of multiple micronutrient supplements for improving micronutrient status, anemia, growth, and morbidity of Indonesian infants. In this double-blind, placebo-controlled trial, 284 infants aged 6-12 mo were randomly allocated to 4 treatment groups for 23 wk; 260 (92%) infants completed the study. Group 1 (DMM) received one adequate intake of multiple micronutrient supplements daily (n ϭ 66); group 2 (WMM) received 2 adequate intakes of multiple micronutrient on 1d plus 6 d of placebo (n ϭ 60); group 3 (DI) received 10 mg of iron supplement daily (n ϭ 69); group 4 received a placebo supplement daily (n ϭ 65). Blood samples were collected at baseline and at posttreatment to assess anemia and micronutrient status. Anthropometric measurements were taken monthly, and morbidity was recorded daily. At baseline, 58.1% of infants were anemic, 34.2% were iron deficient, 21.3% were vitamin A deficient, and 11% were zinc deficient. The DMM and DI supplements both corrected iron deficiency, but DMM supplements were more efficacious in improving hemoglobin levels of anemic infants than the other supplements. However, anemia still persisted in one-third of DMM infants posttreatment. The DMM supplement was more efficacious than WMM or DI supplementation in improving infant status of other micronutrients, including zinc, tocopherol, and riboflavin, whereas DI exacerbated zinc deficiency. There were no significant differences in growth and morbidity among treatment groups, and growth faltering was not prevented. J. Nutr. 135: 639S-645S, 2005. KEY WORDS: • infants • iron • vitamin A • zinc • multiple micronutrient supplement
The Journal of nutrition, 2007
We evaluated the effectiveness of a 2-mo treatment of Sprinkles containing 12.5 mg iron, 5 mg zinc, 400 microg vitamin A, 160 microg folic acid, and 30 mg vitamin C in reducing anemia among children 9- to 24 mo old in Haiti. Ten food distribution points (FDP) where children received take-home rations of fortified wheat-soy blend (WSB) were randomly allocated into 2 groups: 1) Sprinkles-WSB (S-WSB) (6 FDP; n = 254), receiving 30 sachets of Sprinkles monthly for 2 mo; and 2) WSB only (WSB) (4 FDP; n = 161), not receiving Sprinkles. At baseline, anemia prevalence [hemoglobin (Hb) < 100 g/L], adjusted for age and sex, was 54 and 39% in S-WSB and WSB groups, respectively. After the 2-mo intervention (1st follow-up), anemia, adjusted for baseline prevalence, age, and sex dropped to 24% in S-WSB (P < 0.001) and increased to 43% in WSB (P = 0.07). At 7 mo postintervention, anemia in S-WSB declined to 14%; 92% of children who were nonanemic at 1st follow-up remained so without further ...
Journal of Nutrition
Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious. J. Nutr. 135: 646S-652S, 2005. KEY WORDS: • micronutrient supplementation • iron • zinc • anemia • growth faltering • Peru • infants
The Prevalence and Predictors of Iron Deficiency Anemia among Rural Infants in Nablus Governorate
Journal of research in health sciences, 2018
Iron deficiency anemia (IDA) in infants and young children remains a significant public health problem in most developing countries. IDA had short and long-term adverse impacts on infants' health and development. We aimed to assess the frequency of IDA and associated risk factors among infants aged between 9-12 months in rural areas of Nablus Governorate. A cross-sectional study. The study was conducted between Jan and Mar 2015. A random sample of 654 infants aged 9-12 months were selected from thirty villages in Nablus Governorate, Central Highlands of the West Bank, north of Jerusalem. Data were collected using pre-designed structured interviewing questionnaire, complete blood count analysis and anthropometric measurements were done. The prevalence of anemia and IDA among infants was 34.6%, and 32.6%, respectively. Predictors of IDA were increased in infants' age OR=1.19 (95% CI: 1.02, 1.40), maternal anemia during the third trimester OR=2.39 (95% CI: 1.55, 3.71), birth sp...
Israel Journal of Health Policy Research, 2022
Background In 2005, Clalit Health Services (CHS), the largest health maintenance organization in Israel, initiated an intervention program aimed at reducing the prevalence rate of infantile anemia (IA). This study evaluated the progress made during the intervention (2005–2014) and its yield 5 years after it ended (2019). Methods The CHS database was retrospectively reviewed twice yearly from 2005 to 2014 for repetitive samples of children aged 9 to 18 months regarding the previous half-year interval, and a single sample in 2019. Data were collected on gender, ethnicity (Jewish/non-Jewish), socioeconomic class (SEC; low/intermediate/high), hemoglobin testing (yes/no), and hemoglobin level (if tested). Excluded were infants with documented or suspected hemoglobinopathy. Results At study initiation, the rate of performance of hemoglobin testing was 54.7%, and the IA prevalence rate was 7.8%. The performance rate was lower in the Jewish than the non-Jewish subpopulation. The low-SEC sub...