Abstract
In Tanzania's Arusha District, anaemia is a significant public health problem. Recently, home fortification with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be effective. However, it is a challenge for deprived families with low income to afford the daily sachet. The aim of this study was to compare the efficacy of different administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. This research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n=369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either five sachets (n=60), three sachets (n=80), two sachets (n=105), or one sachet (n=124) for six months; 310 children completed the study. Using the HemoCue technique, a finger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin levels. The effect of treatment on haemoglobin was assessed with analysis of covariates with Bonferroni post hoc to test group difference (p > 0.05) from each other. At the end, haemoglobin levels were significantly higher in participants who received three or five sachets of micronutrient powder per week compared to those who received one or two micronutrient powder sachets per week (p < 0.05). The prevalence of illnesses was reduced from 65% to 30.5% in all groups. This finding indicates that economically challenged families may opt for three times per week sachet administration rather than a more costly daily administration. This trial is registered with PACTR201607001693286.
Highlights
Low haemoglobin concentrations, a measure of anaemia, are a significant global challenge at the individual level and at the societal level [1]
Study Area. is study was done in Arusha District, Northern Tanzania. e District is primarily rural with a socioeconomic pattern similar to most rural districts in Tanzania, demonstrates cultural diversity, and reports childhood anaemia higher (84%) than previously reported District average prevalence (58%) [17]
According to the WHO [7], in populations, where the prevalence of anaemia in children under 5 years is 20% or higher, point-of-use fortification of complementary foods (CFs) with iron-containing micronutrient powder (MNP) among young children is recommended to improve the iron status and reduce anaemia. Dietary factors, such as poor intake of iron-rich foods, were identified as a contributing cause of anaemia [17] as the most frequently consumed diets are predominantly plant-based with low iron content and have antinutritional factors which hinder iron absorption
Summary
A measure of anaemia, are a significant global challenge at the individual level (i.e., development and illnesses) and at the societal level (i.e., economic and social capital) [1]. Anaemia as an indicator of micronutrient deficiencies is mainly attributed to iron deficiency and may be associated with vitamin A, folic acid, and vitamin B12 deficiencies and other non-nutritional causes like infection, loss of blood, and genetic disorder [2]. Infants and children are most vulnerable to micronutrient deficiency, given the high vitamin and mineral intake needed to support their rapid growth and adequate development. About 273 million children under the age of five years are affected by anaemia with the majority being located within developing countries [1, 3]. In Tanzania, more than half (57%) of the children under five years of age are anaemic [4].
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