Effect of daily versus once-weekly home fortification with micronutrient Sprinkles on hemoglobin and iron status among young children in rural Bangladesh

Abstract

Background: The effectiveness of commonly suggested public health interventions to control childhood iron-deficiency anemia has been low.

Objective: To determine whether iron provided in Sprinkles daily or in a higher dose once weekly affected hemoglobin, serum ferritin levels, and serum transferrin receptor levels, and to determine whether there were differences in the effects of the two regimens.

Methods: In this cluster-randomized, community-based trial conducted in rural areas of Bangladesh, 136 children aged 12 to 24 months with mild to moderate anemia (hemoglobin 70-109 g/L) were randomly allocated to receive Sprinkles daily (12.5 mg of elemental iron, n = 79) or once weekly (30 mg of elemental iron, n = 73) for 8 weeks. Hemoglobin, serum ferritin, and serum transferrin receptor were assessed at the start and end of the intervention.

Results: In both groups, there were significant increases in hemoglobin and serum ferritin and a significant decrease in serum transferrin receptor (p < .01). There were no significant differences between the groups in the increases in hemoglobin (16.1 +/- 13.2 g/L for the group receiving Sprinkles daily and 12.3 +/- 13.3 g/L for the group receiving Sprinkles once weekly) and serum ferritin (10.6 and 5.7 microg/L, respectively). The decrease in serum transferrin receptor also did not significantly differ between the groups (median, -2.5 and -1.8 mg/L, respectively). The prevalence rates of iron-deficiency anemia, depleted iron stores, and tissue iron deficiency decreased significantly within each group (p < .01), with no significant differences between the groups.

Conclusions: Home fortification of complementary foods with Sprinkles given either daily or once weekly improved iron-deficiency anemia and iron status among young children.