Bangladesh is a poor country, one third of which floods annually during the monsoon rainy season, hampering economic development. Recent surveys in Bangladesh show very high prevalence figures of anemia ranging from 70-90% among young children 6-24 months of age. Pregnant women were next to under-2 children in their vulnerability to develop anemia. Since the year 2003, a number of research studies were completed and some are ongoing in Bangladesh to answer questions about how Sprinkles can be used in program settings. The first clinical trial completed in Bangladesh examined daily versus weekly administration of Sprinkles to young children. The second study examined whether giving 60 Sprinkles sachets flexibly over a period of 3 or 4 months would improve anemia status as well as giving a 60 sachets daily over 2 months in young children. Both studies have implications for how Sprinkles should be distributed in program settings.
With the impact of Sprinkles on decreasing anemia prevalence in children, the needs of a second target group, pregnant women may also be addressed using Sprinkles. In the developing world, iron/folic acid tablets are the main strategy geared to pregnant women to prevent anemia (as recommended by WHO), however compliance is low due to common gastro-intestinal side effects. A clinical trial is underway in pregnant women to compare the effect of iron/folic acid tablets and Sprinkles on anemia status and examine acceptability of both interventions.
Sprinkles given either daily or once weekly significantly improved anemia and iron status indicators.
The percent of children who were successfully treated for anemia and maintained a non-anemic status over time was significantly greater in both the flexible groups as compared to the daily administration group. Caregivers preferred a flexible administration to a daily regimen.