title: Low dose 'Sprinkles'-- an innovative approach to treat iron deficiency anemia in infants and young children.
abstract: 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.
authors.affiliation: Vadu Rural Health Program, Department of Pediatrics, KEM Hospital, Pune, India.
authors.forename: Siddhivinayak
authors.initials: S
authors.lastname: Hirve
authors.forename: Sheila
authors.initials: S
authors.lastname: Bhave
authors.forename: Ashish
authors.initials: A
authors.lastname: Bavdekar
authors.forename: Sadanand
authors.initials: S
authors.lastname: Naik
authors.forename: Anand
authors.initials: A
authors.lastname: Pandit
authors.forename: Claudia
authors.initials: C
authors.lastname: Schauer
authors.forename: Anna
authors.initials: A
authors.lastname: Christofides
authors.forename: Ziauddin
authors.initials: Z
authors.lastname: Hyder
authors.forename: Stanley
authors.initials: S
authors.lastname: Zlotkin
mesh_terms: 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
chemical_list: D004304:Dosage Forms; D006454:Hemoglobins; D005293:Ferritins