Micronutrient Sprinkles reduce anemia among 9- to 24-mo-old children when delivered through an integrated health and nutrition program in rural Haiti.
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 Sprinkles consumption. From baseline to 1st follow-up, mean Hb increased by 5.5 g/L and dropped by 1.0 g/L in the S-WSB and WSB groups, respectively (P < 0.001). From baseline to 2nd follow-up, mean Hb increased by 10.9 g/L in S-WSB (P < 0.001). Changes in mean Hb were greater for younger children (<21 mo at onset of intervention) (P < 0.05) and for children who were anemic at baseline (P < 0.001). In populations with a high prevalence of anemia, such as rural Haiti, 2 mo of Sprinkles are effective in reducing anemia among 9- to 24-mo-old children.
Menon
Purnima
P
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. pm38@cornell.edu
Ruel
Marie T
MT
Loechl
Cornelia U
CU
Arimond
Mary
M
Habicht
Jean-Pierre
JP
Pelto
Gretel
G
Michaud
Lesly
L
D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D002662:Child Health Services; D003371:Cough / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D019587:Dietary Supplements; D005260:Female; D005522:Food Services; D006205:Haiti; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D015999:Multivariate Analysis; D015995:Prevalence; D012424:Rural Population; D013025:Glycine max; D014908:Triticum
D006454:Hemoglobins; D018977:Micronutrients