Double-blind, placebo-controlled trial comparing effects of supplementation with two different combinations of micronutrients delivered as sprinkles on growth, anemia, and iron deficiency in cambodian infants.
OBJECTIVE
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 mug) plus zinc (5 mg) (MMN, n = 68), or iron (12.5 mg) plus folic acid (150 microg) 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-for-age and height-for-age z-scores in any group (P < 0.0001). The rate of recovery from anemia was significant (P < 0.001) and comparable between MMN (54%) and FFA (53%) groups and higher than in the placebo group (22%, P < 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 < 0.0001).


CONCLUSIONS
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.
Department of Pediatrics, San Paolo Hospital, University of Milan, Italy. marcello.giovannini@unimi.it
Marcello
M
Giovannini
Debora
D
Sala
Michele
M
Usuelli
Luca
L
Livio
Gaia
G
Francescato
Marta
M
Braga
Giovanni
G
Radaelli
Enrica
E
Riva
D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000453:epidemiology; D000886:Anthropometry; D002160:Cambodia; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005293:Ferritins / Q000032:analysis; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006128:Growth / Q000187:drug effects*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D015032:Zinc / Q000008:administration & dosage / Q000627:therapeutic use
D006454:Hemoglobins; D018977:Micronutrients; D005293:Ferritins; D005492:Folic Acid; D007501:Iron; D015032:Zinc