title: Point-of-use micronutrient fortification: lessons learned in implementing a preschool-based pilot trial in South Africa.
abstract: This current pilot trial assessed the feasibility of implementing a point-of-use (PoU) micronutrient fortification in preschool settings. Preschool children (n = 151) aged 36-79 months were randomized into intervention (n = 76) and control (n = 75) groups, both receiving breakfast maize-porridge with added micronutrient or placebo powder for 52 school days. Process evaluation and early childhood development indicators were used to assess trial feasibility. Process evaluation results showed that the implementation components were feasible and could be delivered with high fidelity. The improvement in hemoglobin concentration in intervention and control groups were not significantly different (P = 0.250). There was medium likelihood for practical significance for the two global cognitive scores assessed: non-verbal index (intervention effects: 7.20; 95% confidence interval: 2.60, 11.81; P = 0.002, effect size: 0.55) and mental processing index (intervention effects: 2.73; 95% confidence interval: 0.25, 5.70; P = 0.072, effect size: 0.36) on the Kaufman Assessment Battery for Children, Second Edition. The lessons from this trial could help in planning/implementing future PoU micronutrient fortification trial among South African preschool children.
authors.affiliation: Centre of Excellence for Nutrition, North-West University (Potchefstroom Campus), Potchefstroom, South Africa.
authors.forename: Adebayo O
authors.initials: AO
authors.lastname: Ogunlade
authors.forename: H Salome
authors.initials: HS
authors.lastname: Kruger
authors.forename: Johann C
authors.initials: JC
authors.lastname: Jerling
authors.forename: Cornelius M
authors.initials: CM
authors.lastname: Smuts
authors.forename: Namukolo
authors.initials: N
authors.lastname: Covic
authors.forename: Susanna M
authors.initials: SM
authors.lastname: Hanekom
authors.forename: Ramoteme L
authors.initials: RL
authors.lastname: Mamabolo
authors.forename: Jane
authors.initials: J
authors.lastname: Kvalsvig
mesh_terms: D002648:Child; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects*; D002523:Edible Grain; D005069:Evaluation Studies as Topic; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D018977:Micronutrients / Q000008:administration & dosage / Q000494:pharmacology*; D010865:Pilot Projects; D016037:Single-Blind Method; D013019:South Africa; D003313:Zea mays
chemical_list: D006454:Hemoglobins; D018977:Micronutrients