Double-Blind, Placebo-Controlled Trial Comparing Effects of Supplementation with Two Different Combinations of Micronutrients Delivered as Sprinkles on Growth, Anemia, and Iron Deficiency in Cambodian Infants.
Giovannini M, Sala D, Usuelli M, Livio L, Francescato G, Braga M, Radaelli G, Riva E.
Objectives: To assess and compare efficacy of two micronutrient sprinkle supplementation on growth,
anemia, and iron deficiency in Cambodian infants.
Methods: A total of 204 infants aged 6 months and
living in Kompong Chhnang Province, Cambodia were randomly assigned to receive daily supplements of
either iron (12.5 mg) plus folic acid (150 mug) plus zinc (5 mg) (MMN, n = 68), or iron (12.5 mg) plus
folic acid (150 mug) alone (FFA, n = 68), or placebo (n = 68) for a 12 month period in powder form as
sprinkles. Anthropometrics was evaluated bimonthly. Biochemical assessment was performed at baseline and
at the end of intervention period.
Results: At baseline, the overall mean (SD) of hemoglobin
concentration was 101 g/L. No difference among groups was found for growth pattern. Significant decline
was observed for weight-for-age and height-for-age z-scores in any group (P < 0.0001). The rate of
recovery from anemia was significant (P < 0.001) and comparable between MMN (54%) and FFA (53%) groups
and higher than in the placebo group (22%, P < 0.0001). Through the study period, no significant change
in the rate of iron deficiency was found in MMN and FFA groups, whereas it increased in the placebo group (31%, baseline vs. 52%, end of study; P < 0.0001).
Conclusion: Both MMN and FFA supplements were effective for preventing or treating anemia in Cambodian infants and stabilizing plasma levels of ferritin. Use of micronutrients in a controlled home setting, as sprinkled daily supplements,
may be promising in preventing and treating anemia in developing countries.