0
Article | Journal Club

Effect of Micronutrient Sprinkles on Reducing Anemia:  A Cluster-Randomized Effectiveness Trial

Susan J. Jack, MBChB; Kevanna Ou, MD; Mary Chea, MD; Lan Chhin, MD; Robyn Devenish, BSc; Mary Dunbar, MSc; Chanthol Eang, MPH; Kroeun Hou, MPH; Sokhoing Ly, MPH; Mengkheang Khin, MSc; Sophanneary Prak, MD; Ratana Reach, MD; Aminuzzaman Talukder, MPH; La-ong Tokmoh, MPH; Sophia Leon de la Barra, MPhilPH; Philip C. Hill, MD; Peter Herbison, DSc; Rosalind S. Gibson, PhD
Arch Pediatr Adolesc Med. 2012;166(9):842-850. doi:10.1001/archpediatrics.2012.1003.
Text Size: A A A
Published online

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.

Design  Cluster-randomized effectiveness study.

Setting  Cambodian rural health district.

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

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

Main Outcome Measures  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

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Place holder to copy figure label and caption
Grahic Jump Location

Figure 1. Study profile. All subsample children were invited to attend each round regardless of prior attendance. IYCF indicates infant and young child feeding.

Place holder to copy figure label and caption
Grahic Jump Location

Figure 2. Prevalence of iron deficiency anemia (IDA) (hemoglobin level <10.0 g/dL [to convert to grams per liter, multiply by 10.0], ferritin concentration <12 ng/mL [to convert to picomoles per liter, multiply by 2.247] in the absence of infection) (A) and non-IDA (hemoglobin level <10.0 g/dL, ferritin concentration >12 ng/mL) (B) by study group. There were significant differences in the prevalence of IDA at 12 and 18 months (P < .001 and P = .02, respectively) (A) and in the prevalence of non-IDA at 12 months (P = .001).

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME


You need to register in order to view this quiz.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs