Daily use of Sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster-randomized trial.
BACKGROUND
Iron-deficiency anemia is widespread among young children in the Kyrgyz Republic, and there is an urgent need to identify an effective intervention to address this significant public health problem.


OBJECTIVE
To test the effectiveness of a 2-month intervention with daily home fortification of complementary food using micronutrient powder (Sprinkles) in reducing anemia among children 6 to 36 months of age in the Kyrgyz Republic.


METHODS
In this cluster-randomized, community-based effectiveness trial conducted in three regions of the Kyrgyz Republic, 24 clusters of children aged 6 to 36 months were randomly assigned to two groups. The intervention group (12 clusters, n = 1,103) received 60 sachets of micronutrient powder (12.5 mg elemental iron), which were taken as one sachet daily for 2 months. The control group (12 clusters, n = 1,090) did not receive micronutrient powder until after the study period. Blood hemoglobin concentration was assessed at the start and end of the intervention.


RESULTS
From baseline to follow-up, the mean hemoglobin concentration in the intervention group increased by 7 g/L, whereas it decreased by 2 g/L in the control group (p < .001). The prevalence of anemia (hemoglobin < 110 g/L) in the intervention group decreased from 72% at baseline to 52% at follow-up, whereas it increased from 72% to 75% in the control group (p < .001). Compliance with the intervention was high, with children consuming on average 45 of the 60 sachets given.


CONCLUSIONS
A course of 60 Sprinkles micronutrient powder sachets taken daily for 2 months is effective in improving hemoglobin levels and reducing the prevalence of anemia among young children in the Kyrgyz Republic.
Kyrgyz-Swiss-Swedish Health Project, Bishkek, Kyrgyz Republic. elizabeth.lundeen@aya.yale.edu
Elizabeth
E
Lundeen
Tobias
T
Schueth
Nurjan
N
Toktobaev
Stanley
S
Zlotkin
S M Ziauddin
SM
Hyder
Robert
R
Houser
D000375:Aging; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements / Q000009:adverse effects; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007707:Kyrgyzstan / Q000453:epidemiology; D018977:Micronutrients / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D010290:Parents / Q000193:education; D010349:Patient Compliance; D017060:Patient Satisfaction; D011208:Powders; D015995:Prevalence; D011795:Surveys and Questionnaires
D006454:Hemoglobins; D018977:Micronutrients; D011208:Powders