Feasibility and Effectiveness of Distributing Micronutrient Sprinkles to Reduce Prevalence of Anemia

NCT ID: NCT00210405

Last Updated: 2012-08-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-03-31

Study Completion Date

2005-09-30

Brief Summary

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The objective of this study is to test the feasibility and effectiveness of distributing micronutrient sprinkles to 6-20 month old children participating in an integrated maternal and child health and nutrition program in rural Haiti. The micronutrient sprinkles have been formulated to prevent or treat anemia in 6-23 month old children. Effectiveness in reducing the prevalence of anemia will be assessed.

Detailed Description

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Anemia is highly prevalent among infants and young children in Haiti and throughout the world. Low intakes of several micronutrients contribute to this problem. It is very difficult to meet the micronutrient needs of infants and young children without substantial amounts of animal-source foods; such foods are not affordable for most families in many poor communities.

Micronutrient sprinkles are a novel approach to meeting children's needs. The sprinkles are packed in sachets containing a daily ration, and are intended to be used in the home and "sprinkled" directly on the children's food. Earlier trials have shown the efficacy of the sprinkles for preventing and treating anemia under controlled conditions.

The current study tests the feasibility and effectiveness when sprinkles are distributed in the programmatic context of a US Title II food aid distribution program, a context that is common in many countries that receive assistance from the United States Agency for International Development and other donors. The study also includes the development and dissemination of educational messages to motivate and enable caregivers to use the sprinkles properly. Based on previous efficacy trials no side-effects are anticipated, but the study also monitors for unanticipated side-effects.

Comparison: Since effectiveness of the sprinkles distributed as part of a take-home ration has not been established, this study employed a randomized controlled design. Randomization occurred at the level of the food distribution point (place where community members gather to receive food rations). Groups were assigned to receive either the take home ration (usual program practice) or the take home ration and the sprinkles. Families receiving only food rations at the control sites will receive sprinkles along with their food ration immediately after data collection is complete. The design was also consistent with the program necessity of a gradual roll-out of this new intervention. The prevalence of anemia among target-age children will be compared between groups that receive a two-month supply of micronutrient sprinkles with their take-home food ration, and those that do not.

Conditions

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Anemia

Keywords

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Anemia Infant nutrition Dietary supplements Randomized controlled trials Evaluation studies Haiti

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Food aid only

Children in this arm received fortified food aid commodities supplied through the maternal and child health and nutrition program implemented by World Vision. They received fortified corn-soy blend, which contained iron.

Group Type ACTIVE_COMPARATOR

Fortified food aid (corn-soy blend)

Intervention Type DIETARY_SUPPLEMENT

This intervention was part of the overall food assisted maternal and child health and nutrition program, and included fortified food aid commodities. Corn soy blend was targeted to the child, while the family also received wheat, lentils and oil.

Micronutrient sprinkles + food aid

Children in this arm were enrolled in the food assisted program, and therefore received fortified food aid, as well as 60 sachets of a multiple micronutrient powder (Sprinkles) containing iron, zinc, vitamin A, vitamin C and folic acid

Group Type EXPERIMENTAL

"Sprinkles" containing mulitple micronutrients

Intervention Type DIETARY_SUPPLEMENT

Education/communication on use of micronutrient sprinkles

Intervention Type BEHAVIORAL

Fortified food aid (corn-soy blend)

Intervention Type DIETARY_SUPPLEMENT

This intervention was part of the overall food assisted maternal and child health and nutrition program, and included fortified food aid commodities. Corn soy blend was targeted to the child, while the family also received wheat, lentils and oil.

Interventions

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"Sprinkles" containing mulitple micronutrients

Intervention Type DIETARY_SUPPLEMENT

Education/communication on use of micronutrient sprinkles

Intervention Type BEHAVIORAL

Fortified food aid (corn-soy blend)

This intervention was part of the overall food assisted maternal and child health and nutrition program, and included fortified food aid commodities. Corn soy blend was targeted to the child, while the family also received wheat, lentils and oil.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* 6-20 months old at time of recruitment
* Family receives food rations at World Vision-Haiti's Food Distribution Points

Exclusion Criteria

* Severe anemia at time of recruitment (hemoglobin \<7.0 g/dl)
Minimum Eligible Age

6 Months

Maximum Eligible Age

20 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Cornell University

OTHER

Sponsor Role collaborator

World Vision

OTHER

Sponsor Role collaborator

Micronutrient Initiative

OTHER

Sponsor Role collaborator

International Food Policy Research Institute

OTHER

Sponsor Role lead

Principal Investigators

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Marie T. Ruel, PhD

Role: PRINCIPAL_INVESTIGATOR

International Food Policy Research Institute

Purnima Menon, PhD

Role: PRINCIPAL_INVESTIGATOR

International Food Policy Research Institute

Locations

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World Vision-Haiti Regional Office

Hinche, , Haiti

Site Status

Countries

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Haiti

References

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Ruel MT, Menon P, Loechl C, Pelto G. Donated fortified cereal blends improve the nutrient density of traditional complementary foods in Haiti, but iron and zinc gaps remain for infants. Food Nutr Bull. 2004 Dec;25(4):361-76. doi: 10.1177/156482650402500406.

Reference Type BACKGROUND
PMID: 15646314 (View on PubMed)

Zlotkin S, Arthur P, Schauer C, Antwi KY, Yeung G, Piekarz A. Home-fortification with iron and zinc sprinkles or iron sprinkles alone successfully treats anemia in infants and young children. J Nutr. 2003 Apr;133(4):1075-80. doi: 10.1093/jn/133.4.1075.

Reference Type BACKGROUND
PMID: 12672922 (View on PubMed)

Menon P, Ruel MT, Loechl CU, Arimond M, Habicht JP, Pelto G, Michaud L. Micronutrient Sprinkles reduce anemia among 9- to 24-mo-old children when delivered through an integrated health and nutrition program in rural Haiti. J Nutr. 2007 Apr;137(4):1023-30. doi: 10.1093/jn/137.4.1023.

Reference Type RESULT
PMID: 17374671 (View on PubMed)

Loechl CU, Menon P, Arimond M, Ruel MT, Pelto G, Habicht JP, Michaud L. Using programme theory to assess the feasibility of delivering micronutrient Sprinkles through a food-assisted maternal and child health and nutrition programme in rural Haiti. Matern Child Nutr. 2009 Jan;5(1):33-48. doi: 10.1111/j.1740-8709.2008.00154.x.

Reference Type RESULT
PMID: 19161543 (View on PubMed)

Related Links

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http://sghi.org/about_sprinkles/index.html

Sprinkles Global Health Initiative

Other Identifiers

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10-0460-INTFOO-01-3-IFPRI

Identifier Type: -

Identifier Source: org_study_id