Abstract
Introduction Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. This review therefore aims to summarize the evidence published in systematic reviews on intervention strategies that aim at improving micronutrient status in children under the age of five. Methods We searched the literature and included systematic reviews that reported on micronutrient status as a primary outcome for children of 0–5 years old, had a focus on low or middle income countries. Subsequently, papers were reviewed and selected by two authors. Results We included 4235 reviews in this systematic review. We found that (single or multiple) micronutrient deficiencies in pre-school children improved after providing (single or multiple) micronutrients. However home fortification did not always lead to significant increase in serum vitamin A, serum ferritin, hemoglobin or zinc. Commercial fortification did improve iron status. Cord clamping reduced the risk of anemia in infants up to 6 months and, in helminth endemic areas, anthelminthic treatment increased serum ferritin levels, hemoglobin and improved height for age z-scores. Anti-malaria treatment improved ferritin levels. Discussion Based on our results the clearest recommendations are: delayed cord clamping is an effective intervention for reducing anemia in early life. In helminth endemic areas iron status can be improved by anthelminthic treatment. Anti-malaria treatment can improve ferritin. In deficient populations, single iron, vitamin A and multimicronutrient supplementation can improve iron, vitamin A and multimicronutrient status respectively. While the impact of home-fortification on multimicronutrient status remains questionable, commercial iron fortification may improve iron status.
Highlights
Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status
The primary outcome was micronutrient status, in addition we summarized the effect of the interventions on HB and anthropometric outcomes
The aim of this systematic review of systematic reviews was to identify interventions that are effective in improving micronutrient status in children 0–5 years of age
Summary
Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. Micronutrient interventions have been reported to improve both immediate and long-term health effects of micronutrient deficiency. Reported benefits range from reduced prevalence of low birth weight to increased child survival, and improved cognitive development (Bhutta et al 2013). It is still unclear which is most effective in improving micronutrient status, and how it should be provided, e.g. via supplementation, fortification of foods, or treatment of underlying infections.
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