Micronutrient Sprinkles are effective at reducing anemia among children 6-24 months in rural Haiti

Purnima Menon, Marie T Ruel, Cornelia U. Loechl, Mary Arimond, Jean-Pierre Habicht, Gretel Pelto

We evaluated the effectiveness of 2-mo of Sprinkles containing 12.5 mg of Fe, 5 mg Zn, 400 mcg Vit A, 160 mcg folic acid and 30 mg Vit C in reducing anemia (hemoglobin (Hb) <10 g/dL) in children 6 to 20 mo at baseline. Groups of children receiving take-home rations of fortified wheat-soy blend (WSB) in the context of a maternal and child health and nutrition program were randomized to receive (S-WSB) (N=254) or not receive (WSB) (N=161) 30 sachets of Sprinkles for 2 months. At baseline, 53% of S-WSB children and 37% of WSB children were anemic (p<0.05). At endline, anemia dropped to 29% in S-WSB (p=0.00), and increased to 45% (p=0.07) in WSB (p=0.00 for differences in before/after change). Mean endline Hb, adjusted for baseline Hb, age and sex, was higher in the S-WSB group than the WSB group (p=0.00). Mean Hb increased by +0.5 g/dL in the SWSB group (p=0.00), and declined by -0.2 g/dL in the WSB group (p=0.00). Changes in Hb were largest in youngest compared to oldest children (adjusted diff.= +1.08 and +0.10 between treatment groups for children 6- 8.9 mo and 18-20.9 mo at baseline respectively). Effects were also greatest (+0.85 g/dL) among children who were anemic at baseline. The results show that 2 mo of micronutrient Sprinkles are effective in improving Hb levels and reducing anemia in populations with a high prevalence of anemia, such as rural Haiti. A companion abstract (Loechl et al) also demonstrates the feasibility of this delivery system for Sprinkles. [Support: Micronutrient Initiative, World Vision-Haiti, Govt. of Germany; USAID through FANTA/AED]