Impact of Spirulina corn soy blend on Iron deficient children aged 6\u201323\u2009months in Ndhiwa Sub-County Kenya: a randomized controlled trial

Dorothy Apondi Othoo,Elizabeth Kuria,Sophie Ochola,Judith Kimiywe

doi:10.1186/s40795-021-00472-w

Dorothy Apondi Othoo, Elizabeth Kuria + Show 2 more

Open Access

https://doi.org/10.1186/s40795-021-00472-w

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Abstract

BackgroundIron deficiency anemia (IDA) remains high in Kenya despite interventions. Twenty-seven percent of children aged 6 months-14 years are anemic, with low iron intake (7%) among children aged 6–23 months. Standard food interventions involve a corn soy blend (CSB), which is limited in micronutrients, and fortifiers are not accessible locally. Moreover, the use of spirulina as a strategy for mitigating IDA has not been adequately documented. This study compared the impact of a spirulina corn soy blend (SCSB) on IDA among children aged 6–23 months.MethodsA total of 240 children with IDA were randomly assigned to study groups at a ratio of 1:1:1 through lotteries, and caregivers and research assistants were blinded to group assignment. Dry-take-home SCSB, CSB and placebo flour (1.7 kg) was given to caregivers to prepare porridges using a flour water ratio of 1:4, producing 600 ml–700 ml of porridge to feed children 200 ml of porridge three times a day for 6 months. Impact was assessed as plasma hematocrit at baseline and after the study. Blood drawing, preparation and analysis were performed in accordance with approved procedures by the EthicsResearchCommittee. Monthly follow-up and data collection on dietary intake, anthropometry, morbidity and infant feeding practices were performed using questionnaires. Relative risk, magnitude of change and log-rank tests were used to compare the impact of the intervention, and significant differences were determined at P < 0.05.ResultsThe survival probabilities for children consuming SCSB were significantly higher than those consuming CSB (log-rank-X2 = 0.978; CI: 0.954–1.033, P = 0.001) and the placebo (log-rankX2 = 0.971; CI: 0.943–0.984, P = 0.0001). Children consuming SCSB had a mean recovery time of 8 days (CI: 7–12 days) compared to those consuming CSB (19 days; CI: 20–23 days) and placebo (33 days; CI: 3 1–35 days). The recovery rate was 15.4 per 100 persons per day for children who consumed SCSB as opposed to 4.6 and 1.8 per 100 persons per day for those who consumed CSB and the placebo, respectively.ConclusionManagement of IDA with SCSB compared to CSB and the placebo led to faster reversal and large numbers of recoveries from IDA. The recovery rates were above the World Health Organizations (WHO) minimums standards for food interventions. Efforts to realize high and faster recoveries from IDA should be heightened by fortifying CSB with spirulina powder.

Highlights

Iron deficiency anemia (IDA) remains high in Kenya despite interventions
Randomization was successful as reflected in the equivalence in the demographic and socio-economic characteristics assessed at baseline and more so no significant differences between study groups at base line, Table 3
In this study, interventions with Spirulina Corn Soy Blend (SCSB) yielded higher and faster recoveries from iron deficiency among children more than Corn Soy Blend (CSB) and placebo. This can be attributed to the high iron contents of spirulina powder used to fortify corn soy blend (CSB) and high bioavailability though not analyzed in this study

Summary

Introduction

Iron deficiency anemia (IDA) remains high in Kenya despite interventions. Twenty-seven percent of children aged 6 months-14 years are anemic, with low iron intake (7%) among children aged 6–23 months. The disorders can be attributed to a variety of factors including inadequate dietary intakes, low access to adequate and diversified diets, poor infant and young child feeding practices, poor maternal nutrition knowledge and attitudes as influenced by socioeconomic and cultural beliefs, poor sanitation and hygiene practices, childhood illnesses and inadequate access to health and nutrition services [4]. These have contributed to increased childhood morbidity, disability, retarded growth and mental development which together derail realization of Kenya vision 2030 and the Sustainable Development Goals. The children on complementary feeding are at increased risks of inadequate iron intakes given that their foods are composed of non-haem iron compounds whose bioavailability is greatly influenced by other constituents of the diet consumed [5]

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