title: Effect of multiple micronutrient-fortified food on mild morbidity and clinical symptoms in Zambian infants: results from a randomised controlled trial.
abstract: OBJECTIVE
  We aimed to assess the effects on mild morbidity of a richly micronutrient-fortified complementary/replacement food given to Zambian infants aged 6-18 months. Previous results (The Chilenje Infant Growth, Nutrition and Infection Study Team, 2010) showed an increase in the rate of hospital referral for pneumonia in the same cohort.
  
  
  METHODS
  A total of 743 six-month-old healthy Zambian infants were randomised to receive either a richly or a basal micronutrient-fortified porridge for 12 months. Mild morbidity was defined as an illness that did not cause death or require hospitalisation and was diagnosed on clinical examination at scheduled visits.
  
  
  RESULTS
  There was no evidence of an effect of trial arm on overall mild morbidity during the study (odds ratio (OR)=1.04, 95% confidence interval (CI)=0.90, 1.20, P=0.62). Infants in the richly fortified arm had significantly more visits in which they were diagnosed with lower respiratory tract infections/pneumonia (OR=1.65, 95% CI=1.06, 2.59, P=0.03) and fewer visits in which a diagnosis of urinary tract infection was made (OR=0.43, 95% CI=0.21, 0.87, P=0.02). Maternally reported symptoms were similar between trial arms.
  
  
  CONCLUSIONS
  Compared with the basal diet, the richly micronutrient-fortified food was associated with more episodes of lower respiratory infections/pneumonia diagnosed at scheduled visits, which reinforces our previously reported findings of a higher incidence in hospital referral for pneumonia.
authors.affiliation: Department of Nutrition and Public Health Intervention Research, London School of Hygiene and Tropical Medicine, London, UK. daniela.manno@lshtm.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Manno
authors.forename: J
authors.initials: J
authors.lastname: Siame
authors.forename: N
authors.initials: N
authors.lastname: Larke
authors.forename: K
authors.initials: K
authors.lastname: Baisley
authors.forename: L
authors.initials: L
authors.lastname: Kasonka
authors.forename: S
authors.initials: S
authors.lastname: Filteau
mesh_terms: D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D016017:Odds Ratio; D011014:Pneumonia / Q000150:complications / Q000178:diet therapy* / Q000453:epidemiology*; D015995:Prevalence; D015024:Zambia / Q000453:epidemiology
chemical_list: D018977:Micronutrients