Effect of micronutrient sprinkles on reducing anemia: a cluster-randomized effectiveness trial.
OBJECTIVE
To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants.


METHODS
Cluster-randomized effectiveness study.


METHODS
Cambodian rural health district.


METHODS
Among 3112 infants aged 6 months, a random subsample (n = 1350) was surveyed at baseline and 6-month intervals to age 24 months.


METHODS
Daily micronutrient Sprinkles alongside IYCF education vs IYCF education alone for 6 months from ages 6 to 11 months.


METHODS
Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry.


RESULTS
Anemia prevalence (hemoglobin level <11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P = .001), and the prevalence of moderate anemia (hemoglobin level <10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; P < .001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6-29.1; P < .001) and 11.6% (95% CI, 2.6-17.9; P = .02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 μg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26-5.42; P = .03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time.


CONCLUSIONS
Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12608000069358.
World Health Organization.
Susan J
SJ
Jack
Kevanna
K
Ou
Mary
M
Chea
Lan
L
Chhin
Robyn
R
Devenish
Mary
M
Dunbar
Chanthol
C
Eang
Kroeun
K
Hou
Sokhoing
S
Ly
Mengkheang
M
Khin
Sophanneary
S
Prak
Ratana
R
Reach
Aminuzzaman
A
Talukder
La-Ong
LO
Tokmoh
Sophia
S
Leon de la Barra
Philip C
PC
Hill
Peter
P
Herbison
Rosalind S
RS
Gibson
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000517:prevention & control*; D000886:Anthropometry; D016000:Cluster Analysis; D019587:Dietary Supplements; D005293:Ferritins / Q000378:metabolism; D006130:Growth Disorders / Q000209:etiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D000090463:Iron Deficiencies; D018977:Micronutrients / Q000008:administration & dosage*; D012177:Retinol-Binding Proteins / Q000378:metabolism; D014802:Vitamin A Deficiency / Q000097:blood / Q000517:prevention & control; D015032:Zinc / Q000172:deficiency
D006454:Hemoglobins; D018977:Micronutrients; D012177:Retinol-Binding Proteins; D005293:Ferritins; D015032:Zinc