THE EFFECTIVENESS OF FLEXIBLE ADMINISTRATION OF SPRINKLES IN ANEMIC AND NON-ANEMIC INFANTS AND YOUNG CHILDREN IN RURAL BANGLADESH

Hedy Ip, SM Ziauddin Hyder, Farhana Haseen, Mizanur Rahman, Stanley H Zlotkin

Background: Sprinkles are a new complementary food supplement that delivers iron (12.5mg) and other micronutrients in powder form. Effective strategies to promote the use of Sprinkles are needed.

Objective: To compare daily vs. flexible administration of Sprinkles on hemoglobin (Hb), adherence and caregiver acceptance in a community-based setting.

Methods: 362 infants, 6-24 mo with Hb > 70g/L, were cluster randomized into groups: 1) Daily use of 60 sachets over 2 months; 2) Flexible use of 60 sachets over 3 months; or 3) Flexible use of 60 sachets over 4 months. Caregivers were instructed to give no more than one sachet a day with weaning food. Hb was measured at baseline and end of each intervention period. Adherence was assessed by counting the number of sachets used. Acceptability was assessed by survey and focus group discussions.

Results: Groups did not differ in mean baseline Hb (99±14 g/L, x±SD). Mean Hb increased significantly from baseline to end for all groups (p<0.01); group 3 had significantly higher mean end Hb (116±12 g/L) vs. groups 1 (109±15 g/L) and 2 (112±12 g/L), and highest mean compliance (98%) vs. groups 1 (88%) and 2 (93%). Flexible use was preferred by many mothers who reported benefits of more freedom, less anxiety and more time to finish using sachets.

Conclusion: Flexible use of 60 sachets over 4 months may be the most effective strategy for community Sprinkles distribution. Supported by HJ Heinz Co. Foundation.