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Randomized Controlled Trial
. 2021 Jun 23;13(7):2160.
doi: 10.3390/nu13072160.

Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial

Malaine Morais Alves Machado  1 , Mirella de Paiva Lopes  2 , Raquel Machado Schincaglia  3 , Paulo Sérgio Sucasas da Costa  4 , Alexandre Siqueira Guedes Coelho  5 , Maria Claret Costa Monteiro Hadler  1   2   5
Affiliations
Randomized Controlled Trial

Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial

Malaine Morais Alves Machado et al. Nutrients. .

Abstract

Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.

Keywords: anaemia; children; deficiency diseases; iron deficiency; micronutrients.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Profile of this randomized clinical trial. The Early Childhood Education Center (CMEI) that received allocation for multiple micronutrients powder (MNP) in a health district had its peer in the same health district receiving ferrous sulphate and folic acid (FS_FA), defined by lot, totaling 10 CMEIs (5 MNP and 5 FS_FA). Within each of these CMEIs, if children were anaemic, they received the dose corresponding to the anaemia treatment recommendation, and if they were not anaemic, they received the dose corresponding to the prevention of anaemia. The number of children included in the intention-to-treat analysis corresponded to those for whom initial and final hemoglobin levels were measured.
Figure 2
Figure 2
Average estimates of hemoglobin (a), serum ferritin (b), and soluble transferrin receptor (c) levels for each group and intervention in the two evaluation periods. Estimates of means with non-overlapping error bars differ statistically from each other, at a 5% level of significance.
Figure 2
Figure 2
Average estimates of hemoglobin (a), serum ferritin (b), and soluble transferrin receptor (c) levels for each group and intervention in the two evaluation periods. Estimates of means with non-overlapping error bars differ statistically from each other, at a 5% level of significance.
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