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children 12-23 months in Eastern Uganda
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4 01 2020
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Source: J Nutr. 150(4):938-944
[PDF-354.36 KB]
Details:
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Alternative Title:J Nutr
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Personal Author:
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Description:Background:
Micronutrient powders (MNP) can reduce iron deficiency and anemia in children.
Objective:
We evaluated the impact of an integrated infant and young child feeding (IYCF) – MNP intervention on anemia and micronutrient status among children 12–23mo in Eastern Uganda. The intervention focused on MNP distribution, IYCF education, and caregiver behavior change.
Methods:
Population-based cross-sectional surveys representative of children 12–23mo in Amuria (intervention) and Soroti (non-intervention) districts were collected in June/July 2015 at baseline (n=1,260) and 12 months after implementation at endline in 2016 (n=1,490). From pooled capillary blood, we assessed hemoglobin (Hb), malaria, ferritin, retinol binding protein (RBP), C-reactive protein, and alpha-1 acid glycoprotein. Ferritin and RBP were regression-adjusted to correct for inflammation. Caregivers reported sociodemographic characteristics and MNP knowledge and practices. Linear regression estimated the difference-in-difference (DiD) effect of MNP on Hb, ferritin, and RBP and logistic regression estimated DiD effect of MNP on anemia (Hb <11.0 g/dL), iron deficiency (ferritin <12.0 μg/L), iron deficiency anemia (Hb <11.0 g/dL and ferritin <12.0 μg/L), and vitamin A deficiency (VAD) (RBP equivalent to <0.70 μmol/L retinol: <0.79 μmol/L at baseline and RBP <0.67 μmol/L at endline).
Results:
In Amuria, 96% of children had ever consumed MNP vs. <1% of children in Soroti. Fifty-four percent of caregivers reported organoleptic changes when MNP were added to foods cooked with soda ash. Adjusting for age, sex, malaria, recent morbidity, and household-level factors, the intervention was associated with −0.83 g/dL lower Hb (95% CI −1.36, −0.30 g/dL; P=0.003) but not with anemia, ferritin, iron deficiency, iron deficiency anemia, RBP, or VAD.
Conclusion:
Despite high program fidelity, the intervention was associated with reduced Hb concentrations but not with change in anemia or micronutrient status among children 12–23 months in Eastern Uganda. Contextual factors, like cooking with soda ash, might explain the lack of effectiveness.
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Pubmed ID:31923315
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Pubmed Central ID:PMC8127862
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Volume:150
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Issue:4
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