Low dose 'Sprinkles'-- an innovative approach to treat iron deficiency anemia in infants and young children.
Iron supplementation programs using pediatric tablets or drops have not been successful in the control of anemia amongst infants and children in India. Sprinkles is an innovative multi-micronutrient home fortification strategy to control iron deficiency and anemia.


OBJECTIVE
We aimed to determine the hematologic response to different doses and forms of iron in Sprinkles and iron drops.


METHODS
Twenty two villages of Vadu Rural Health Program, KEM Hospital, Pune.


METHODS
Double blind clustered randomized community-based trial.


METHODS
Children (n=432) aged 6 to 18 mo age with Hb between 70 to 100 g/L were enrolled.


METHODS
Selected villages were randomized into 5 groups: Sprinkles 12.5, 20 or 30 mg ferrous fumarate, Sprinkles 20 mg micronized ferric pyrophosphate or drops 20 mg ferrous glycine sulphate (DROPS) for 8 weeks. Household socio-demographic information was collected at baseline. Side effects and compliance were monitored through weekly visits. Hemoglobin was estimated at baseline, 3 and 8 weeks. Ferritin was assessed at baseline and 8 weeks.


RESULTS
Baseline characteristics were similar across all groups. Hemoglobin increased significantly (P<0.0001) in all groups at 8 weeks with no difference between groups. Ferritin increased (P<0.0001) significantly in all groups with no difference across the groups. Compliance (overall range: 42 to 62 %) was lowest for DROPS. Side effects were significantly higher among DROPS compared to Sprinkles (p>0.05).


CONCLUSIONS
Sprinkles 12.5 mg FF dose is as efficacious as higher doses of iron in Sprinkles or DROPS in increasing hemoglobin. Sprinkles FF 12.5 mg is recommended as it has fewer reported side effects and better compliance compared to DROPS.
Hirve
Siddhivinayak
S
Vadu Rural Health Program, Department of Pediatrics, KEM Hospital, Pune, India.
Bhave
Sheila
S
Bavdekar
Ashish
A
Naik
Sadanand
S
Pandit
Anand
A
Schauer
Claudia
C
Christofides
Anna
A
Hyder
Ziauddin
Z
Zlotkin
Stanley
S
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000628:therapy*; D019587:Dietary Supplements / Q000009:adverse effects; D004304:Dosage Forms; D004311:Double-Blind Method; D005293:Ferritins / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D012959:Socioeconomic Factors
D004304:Dosage Forms; D006454:Hemoglobins; D005293:Ferritins