Effect of Providing Multiple Micronutrients in Powder through Primary Healthcare on Anemia in Young Brazilian Children: A Multicentre Pragmatic Controlled TrialReport as inadecuate




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Background

Multiple micronutrients in powder MNP are recommended by WHO to prevent anemia in young children. However, evidences for its effectiveness in different populations and improvements in other outcomes e.g. linear growth and vitamin A deficiency are scarce.

Methods

A multicentre pragmatic controlled trial was carried out in primary health centres. At study baseline, a control group CG of children aged 10- to 14 months n = 521 was recruited in the routine healthcare for assessing anemia, anthropometric and micronutrient status. At the same time, an intervention group IG of infants aged 6- to 8 months n = 462 was recruited to receive MNP daily in complementary feeding over a period of 60 days. Both study groups were compared when the IG infants reached the age of the CG children at enrolment.

Results

In CG, the prevalence of anemia hemoglobin Hb < 110 g-L, iron deficiency ID, plasma ferritin < 12 μg-L or TfR > 8.3 mg-L, and vitamin A deficiency VAD, serum retinol < 0.70μmol-L were 23.1%, 37.4%, and 17.4%, respectively. Four to six months after enrolment, when the IG participants had the same age of the controls at the time of testing, the prevalence of anemia, ID and VAD in IG were 14.3%, 30.1% and 7.9%, respectively. Adjusting for city, health centre, maternal education, and age, IG children had a lower likelihood of anemia and VAD Prevalence Ratio 95% CI = 0.63 0.45, 0.88 and 0.45 0.29, 0.69, respectively when compared with CG children. The adjusted mean distributions of Hb and length-for-age Z-scores improved by 2 SE in the IG compared to CG children.

Conclusions

MNP effectively reduced anemia and improved growth and micronutrient status among young Brazilian children.

Trial Registration

Registro Brasileiro de Ensaios Clinicos RBR-5ktv6b



Author: Marly A. Cardoso , Rosangela A. Augusto, Gisele A. Bortolini, Cristieli S. M. Oliveira, Daniela C. Tietzman, Leopoldina A. S. Seq

Source: http://plos.srce.hr/



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