NDLI: Selling Sprinkles micronutrient powder reduces anemia, iron deficiency, and vitamin A deficiency in young children in Western Kenya: a cluster-randomized controlled trial.

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Selling Sprinkles micronutrient powder reduces anemia, iron deficiency, and vitamin A deficiency in young children in Western Kenya: a cluster-randomized controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Suchdev, Parminder S. Ruth, Laird J. Woodruff, Bradley A. Mbakaya, Charles Mandava, Usha Flores-Ayala, Rafael Jefferds, Maria Elena D. Quick, Robert
Spatial Coverage	Kenya
Description	Country affiliation: United States Author Affiliation: Suchdev PS ( Nutrition Branch, CDC, Atlanta, GA 30341, USA. psuchdev@cdc.gov)
Abstract	BACKGROUND: Although the efficacy of micronutrient powders [MNPs; eg, Sprinkles MNP (Sprinkles Global Health Initiative)] in the reduction of anemia has been established, the effectiveness of these powders in real-world programs has seldom been assessed. OBJECTIVE: In this study, we evaluated the effect of community-based marketing and distribution of Sprinkles MNP on childhood rates of anemia and iron and vitamin A deficiency. DESIGN: In a cluster-randomized trial in children aged 6-35 mo in Western Kenya, 60 villages were randomly assigned to either intervention or control groups. Community vendors marketed and sold sachets of Sprinkles MNP in intervention villages. Biweekly household visits monitored the use of Sprinkles MNP. Hemoglobin, ferritin, retinol binding protein, malaria, and anthropometric measures were assessed at baseline (n = 1063) and 12 mo of follow-up (n = 862). Data were analyzed by using an intention-to-treat analysis and generalized linear mixed models. RESULTS: On average, 33% of households in intervention villages purchased Sprinkles MNP; the average weekly intake per child was 0.9 sachets (â¼11.3 mg Fe and â¼328 µg vitamin A). Compared with control subjects, intervention children had greater improvements in hemoglobin concentrations (increase of 0.9 compared with 0.6 g/dL, respectively; P = 0.02), iron deficiency (decrease of 19.3% compared with 5.3%, respectively; P = 0.001), and vitamin A deficiency (decrease of 7.5% compared with an increase of 2.5%, respectively; P = 0.01). Results adjusted for age, sex, socioeconomic status, and maternal education showed a significant association between the hemoglobin, iron, and vitamin A concentrations of children and the number of Sprinkles MNP sachets the children consumed. The prevalence of malaria, wasting, and stunting did not change significantly in either group. CONCLUSION: Even with relatively low and infrequent use, Sprinkles MNP sales through community vendors were associated with decreased rates of anemia and iron and vitamin A deficiency in children in a resource-poor setting. This trial was registered at clinicaltrials.gov as NCT01088958.
File Format	HTM / HTML
ISSN	00029165
e-ISSN	19383207
DOI	10.3945/ajcn.111.030072
Journal	American Journal of Clinical Nutrition
Issue Number	5
Volume Number	95
Language	English
Publisher	American Society for Nutrition
Publisher Date	2012-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Nutritional Sciences Anemia, Iron-deficiency Epidemiology Dietary Supplements Iron, Dietary Administration & Dosage Micronutrients Vitamin A Deficiency Vitamin A Drug Therapy Child, Preschool Cluster Analysis Ferritins Blood Hemoglobins Metabolism Infant Kenya Malaria Randomized Controlled Trial Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Medicine

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Selling Sprinkles micronutrient powder reduces anemia, iron deficiency, and vitamin A deficiency in young children in Western Kenya: a cluster-randomized controlled trial.