title: Treatment of anemia with microencapsulated ferrous fumarate plus ascorbic acid supplied as sprinkles to complementary (weaning) foods.
abstract: BACKGROUND
  Standard therapy for anemia in infants is ferrous sulfate drops administered 3 times/d. Adherence to treatment, however, is often poor. One likely reason for poor adherence is the unpleasant side effects associated with drops.
  
  
  OBJECTIVE
  The objective was to evaluate the use of a new form of iron and a delivery system to treat anemia in infants that is likely to produce better adherence to treatment.
  
  
  METHODS
  Using a prospective, randomized, controlled design, we studied 557 anemic children aged 6-18 mo (hemoglobin: 70-99 g/L) in rural Ghana. One group received a daily sachet of microencapsulated ferrous fumarate (80 mg elemental Fe) in powder form plus ascorbic acid to be sprinkled onto any complementary food eaten (sprinkles group); a control group received ferrous sulfate drops 3 times/d for 2 mo (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment.
  
  
  RESULTS
  Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles group and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased significantly in each group from baseline to the end of treatment (P < 0.001).
  
  
  CONCLUSIONS
  Use of ferrous sulfate drops or a single daily dose of microencapsulated ferrous fumarate sprinkles plus ascorbic acid resulted in a similar rate of successful treatment of anemia without side effects. To our knowledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia. Improved ease of use may favor the use of sprinkles to deliver iron.
authors.affiliation: Departments of Paediatrics and Nutritional Sciences, the University of Toronto, Canada. zlotkin@sickkids.on.ca
authors.forename: S
authors.initials: S
authors.lastname: Zlotkin
authors.forename: P
authors.initials: P
authors.lastname: Arthur
authors.forename: K Y
authors.initials: KY
authors.lastname: Antwi
authors.forename: G
authors.initials: G
authors.lastname: Yeung
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy*; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004339:Drug Compounding; D004359:Drug Therapy, Combination; D005260:Female; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005869:Ghana; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007225:Infant Food; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D012424:Rural Population; D014886:Weaning
chemical_list: D005296:Ferrous Compounds; D006454:Hemoglobins; D005293:Ferritins; D001205:Ascorbic Acid; C031621:ferrous fumarate